A 45-year-old male patient with spur cell anemia was treated by plasmapheresis. At first, a membrane plasma separator was employed six times successively to try to prevent the progressive anemia. No significant improvement was achieved with respect to hematological parameters of hemolysis. A discontinuous flow centrifuge was then used four times consecutively. The spur cell count decreased and the progression of the anemia was transiently interrupted after every plasmapheresis of this type. Sequential measurements of the free cholesterol/phospholipid (FC/PL) molar ratio of the red cell membrane lipid revealed the importance of a plasma factor for spur cell formation. It showed that abnormal changes in FC/PL ratio of the red cell membrane were entirely dependent on a precursory change in the lipid composition of the patient\u27s plasma. Although, to our knowledge, plasmapheresis to treat spur cell anemia has not yet been recorded in the literature, in our experience, this therapeutic measure is recommendable for patients with spur cell anemia unresponsive to other forms of treatment
