Indications for plasmapheresis in a patient with plasma hyperviscosity:
(1) resistance to cytotoxic drugs and/or unacceptable side effects limiting their use
(2) serious cardiovascular complications
(3) serious neurological complications
(4) serious coagulation complications, with uncontrolled bleeding
(5) serious renal complications
Cardiovascular complications:
(1) congestive heart failure resistant to standard therapy
(2) angina pectoris resistant to standard therapy
(3) impending peripheral vascular disease with gangrene
Neurological complications:
(1) paraproteinemic coma
(2) seizures
(3) impending stroke
(4) deafness
(5) loss of vision
(6) psychoses
