Subcutaneous immunoglobulins in patients with multiple myeloma and secondary hypogammaglobulinemia: a randomized trial

Clin Immunol. 2018 Jun:191:110-115. doi: 10.1016/j.clim.2017.11.014. Epub 2017 Nov 28.

Abstract

Multiple myeloma is commonly associated with a reduction of non-paraprotein immunoglobulins, resulting in a higher risk of infections that represent the leading cause of the patients' death. Therefore, immunoglobulin replacement therapy appears a logical approach. A total number of 46 myeloma patients were randomly enrolled: 24 of them were assigned to receive subcutaneous immunoglobulins, and 22 were controls. The primary endpoint was the evaluation of the annual rate of severe infections in immunoglobulins-receiving patients as compared with those untreated. Subcutaneous immunoglobulins-treated patients showed a significantly lower number of severe infections per year. Adverse events were limited to the site of infusion and were easily manageable. Health-related quality of life was significantly better in subcutaneous immunoglobulins-receiving patients. By decreasing the rate of infections, the prophylactic administration of SCIg improves both adherence to chemotherapy and health-related quality of life, and is cost-effective by reducing the need of hospitalization and the use of antibiotics.

Keywords: Hypogammaglobulinemia; Infections; Multiple myeloma; Quality of life; Subcutaneous immunoglobulin.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Agammaglobulinemia / drug therapy*
  • Agammaglobulinemia / immunology
  • Agammaglobulinemia / psychology
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulins / administration & dosage*
  • Immunoglobulins / adverse effects
  • Infusions, Subcutaneous
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / immunology
  • Multiple Myeloma / psychology
  • Quality of Life

Substances

  • Immunoglobulin G
  • Immunoglobulins