Immunoglobulin substitution in patients with secondary antibody deficiency in chronic lymphocytic leukemia and multiple myeloma: a representative analysis of guideline adherence and infections.
Guidelines
Hematological malignancies
Immunoglobulin replacement therapy
Infections comorbidity
Secondary IgG deficiency
Journal
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
ISSN: 1433-7339
Titre abrégé: Support Care Cancer
Pays: Germany
ID NLM: 9302957
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
10
08
2021
accepted:
12
02
2022
pubmed:
9
3
2022
medline:
30
4
2022
entrez:
8
3
2022
Statut:
ppublish
Résumé
In secondary immunodeficiency, immunoglobulin replacement therapy (IgRT) is recommended by guidelines (GL) for patients with IgG level < 4 g/l and more than 3 infections or a severe infection. IgRT may be appropriate if IgG level < 4 g/l and/or 1-3 less severe infections (≤ grade 2). This was a retrospective sample analysis representative for practices and hospitals in Germany. The treatments and infection data were collected from patients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM). GL adherence (GLAD) was analyzed. Data from 1086 patients (CLL 490, MM 596) were collected from 86 centers. Of all patients, 34.8% developed IgG deficiency during therapy (CLL 35.5%; MM 34.2%). IgRT was given in 23.5% of CLL and 14.4% of MM patients. GLAD in hypogammaglobulinemia and indication to IgRT was 23.3% of 86 CLL and 22.1% of 77 MM patients. Without GLAD, the hazard ratio (HR) for any infection was 4.49 (95% CI 3.72-5.42; p < 0.001) and for severe infections (grade ≥ 3) 10.64 (95% CI 7.54-15.00; p < 0.001). Significant independent risk factors for infections were a higher Charlson Comorbidity Index, IgG deficiency, and 3 Guideline adherence correlated with fewer and less severe infections but was low in patients with indication to IgRT. Risk factors for infection can be identified. Risk of severe infections was significantly lower in patients with IgRT.
Identifiants
pubmed: 35257229
doi: 10.1007/s00520-022-06920-y
pii: 10.1007/s00520-022-06920-y
pmc: PMC9046374
doi:
Substances chimiques
Immunoglobulin G
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5187-5200Subventions
Organisme : Baxalta GmbH, now part of Takeda
ID : Investigator-Initiated Research grant no. IISR-2019-104350/ IIR-DE-002696
Organisme : aio-studien-ggmbh of the german cancer society
ID : AIO-SUP-0119/ass
Informations de copyright
© 2022. The Author(s).
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