[Immunoglobulin substitution in patients with indolent non-Hodgkin's lymphoma]

Dtsch Med Wochenschr. 2015 Sep;140(19):e201-6. doi: 10.1055/s-0041-102631. Epub 2015 Sep 24.
[Article in German]

Abstract

Background: Infections are major complications in chronic lymphoproliferative disorders, among them indolent non-Hodgkin's lymphoma (iNHL) including chronic lymphocytic leukemia, follicular lymphoma and multiple myeloma.We report on a retrospective cohort analysis of outpatients with indolent non-Hodgkin's lymphoma who were treated in an oncology / hematology group practice and received intravenous polyvalent immunoglobulin G (IVIG) as supportive care. The aim was to describe the treated iNHL population, the course of therapy and the effects of IVIG administrations on the levels of immunoglobulin G (IgG), the incidence of infections and the survival time.

Patients and method: 57 patients with secondary iNHL antibody deficiencies (n = 46) or IgG subclass deficiencies (n = 11) who received IVIG substitution were included. Patients received median 11 IVIG doses with a mean dose of 28 g over a period of median 9.5 months.

Results: Mean IgG levels increased with IVIG substitution at about twice and then remained within the normal range. The incidence of infections decreased in 46 % of treated patients. Effects on survival could not be observed. Median overall survival was in the group of substituted patients 124 months (range 7-124), the control group had a median survival time of 96 months (range 3-129) (p = 0.537).

Conclusion: IgG levels should be reviewed during IVIG substitution on a regular basis and dosage and intervals should be adjusted individually.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulins, Intravenous* / administration & dosage
  • Immunoglobulins, Intravenous* / therapeutic use
  • Immunologic Factors* / administration & dosage
  • Immunologic Factors* / therapeutic use
  • Incidence
  • Infections* / chemically induced
  • Infections* / drug therapy
  • Infections* / epidemiology
  • Infections* / mortality
  • Lymphoma, Non-Hodgkin* / complications
  • Lymphoma, Non-Hodgkin* / drug therapy
  • Lymphoma, Non-Hodgkin* / epidemiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Analysis

Substances

  • Antineoplastic Agents
  • Immunoglobulin G
  • Immunoglobulins, Intravenous
  • Immunologic Factors