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A French observational study describing the use of human polyvalent immunoglobulins in hematological malignancy‐associated secondary immunodeficiency
Author(s) -
Benbrahim Omar,
Viallard JeanFrançois,
Choquet Sylvain,
Royer Bruno,
Bauduer Frédéric,
Decaux Olivier,
Crave JeanCharles,
Fardini Yann,
Clerson Pierre,
Lévy Vincent
Publication year - 2018
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13078
Subject(s) - medicine , hypogammaglobulinemia , image guided radiation therapy , lymphoma , immunodeficiency , chronic lymphocytic leukemia , radiation therapy , leukemia , oncology , antibody , immunology , immune system
Objective To describe the characteristics of patients suffering from secondary immunodeficiencies ( SID ) associated with hematological malignancies ( HM ), who started immunoglobulin replacement therapy (Ig RT ), physicians’ expectations regarding Ig RT , and Ig RT modalities. Methods Non‐interventional, prospective French cross‐sectional study. Results The analysis included 231 patients (66 ± 12 years old) suffering from multiple myeloma ( MM ) (N = 64), chronic lymphoid leukemia ( CLL ) (N = 84), aggressive non‐Hodgkin B‐cell lymphoma ( aNHL ) (N = 32), indolent NHL (N = 39), acute leukemia (N = 6), and Hodgkin disease (N = 6). Of the HM , 47% were currently treated, 42% were relapsing or refractory, 23% of patients had received an autologous hematopoietic stem‐cell transplant, and 1% had received an allograft. Serum immunoglobulin trough levels in 195 individuals were less than 5 g/L in 68.7% of cases. Most patients had a history of recurrent infections. Immunoglobulin dose was about 400 mg/kg/mo. Half of patients started with subcutaneous infusion. When starting Ig RT , physicians mainly expected to prevent severe and moderate infections. They also anticipated improvement in quality of life and survival which is beyond evidence‐based medicine. Conclusion NHL is a frequent condition motivating Ig RT besides well‐recognized indications. Physicians mainly based the decision of starting Ig RT on hypogammaglobulinemia and recurrence of infections but, irrespective of current recommendations, were also prepared to start Ig RT prophylactically even in the absence of a history of infections.