Adsorption of Bence-Jones protein to polymethylmethacrylate membrane in primary amyloidosis.

Primary amyloidosis is an incurable disease though high dose melphalan chemotherapy sometime achieves some efficacy in certain patients. The success of the melphalan chemotherapy appears to be associated with reduction of amyloidogenic immunoglobulin light chain (Bence-Jones Protein; BJP). Thus, in an attempt to reduce the BJP load, we conducted adsorption of BJP using polymethylmethacrylate (PMMA) membrane in a patient with primary amyloidosis suffering nephritic syndrome, who chose not to receive high dose melphalan chemotherapy. Following adsorption, the patient reported an improvement of sensory disturbance in fingers. This was confirmed by markedly improved sensory nerve action potential. Western blot analysis of patient's serum also revealed a significant reduction of both multimer and monomer of BJP following adsorption using the PMMA membrane. These results suggest that removal of BJP by PMMA membrane could serve as an alternate therapeutic method in the treatment of primary amyloidosis.