Exchange transfusion and pre‐filter apheresis dilution for hyperviscosity syndrome refractory to conventional therapeutic plasma exchange in a patient with <scp>IgA</scp> multiple myeloma

This case highlights the importance of prompt recognition of HVS in patients presenting with hematological malignancies. The use of manual exchange transfusion, in conjunction with pre-filter dilution, enabled the successful management of a patient with severe HVS in whom conventional TPE was not possible, illustrating an effective alternative approach in urgent hematological care. It also emphasizes the importance of initiating systemic treatment rapidly for the underlying hematological condition to ensure sustained improvement and prevent recurrence of HVS.