Haematology
Contributions
Type: Publication Only
Background
Intravenous immunoglobulin (IVIg) has been shown to reduce the risk of infections in unselected patients with hypogammaglobulinemia secondary to hematological malignancies. It is not known whether a history of infections can predict benefit from IVIg and can therefore by used to select patients for therapy
Aims
To determine the risk of serious infections when selecting hematological patients for IVIg based on a history of infections and IgG levels.
Methods
A retrospective review of the rate of hospitalisation for infections before and during IVIg therapy in hematological malignancy patients selected for therapy on the basis of serious or recurrent infections was conducted. Results were compared with hypogammaglobulinemic haematology patients not selected for therapy. Characteristics of the groups were compared with Chi-squared tests and event rates expressed as rate ratios with estimated variance to determine 95% confidence limits.
Results
A total of 35 treated patients were treated with IVIg for 1194 months and had 776 months of observations prior to starting treatment. By comparison 57 patients with low IgG levels were identified with hypogammaglobulinemia (IgG<7g/L) who did not require IVIg, with the total observational period being 2587 months. The untreated group had fewer cases with severe hypogammaglobulinemia (51% v 77%, p<0.01) but were otherwise similarly matched for diagnosis, age and sex.
The treated group showed a rate of hospitalisation for bacterial infection of 0.42 per patient year prior to treatment, reducing to 0.14 (relative risk 3.1 (1.6-5.9) for infection prior to treatment). The risk of infection prior to treatment also compared favourably to the 0.08 hospitalisation per patient year in those never treated (relative risk 5.5 (3.0-10)). An IgG level of <4g/L did not predict rates of infection compared with an IgG level >4g/L in either the untreated group or the treated group prior to the commencement of IVIg.
Summary
In this retrospective study, selecting hypogammaglobulinemic hematology patients to have IVIg given or withheld on the basis of a history of infections appears safe and effective.
Keyword(s): Infection, Intravenous gamma-globulin
Session topic: Publication Only
Type: Publication Only
Background
Intravenous immunoglobulin (IVIg) has been shown to reduce the risk of infections in unselected patients with hypogammaglobulinemia secondary to hematological malignancies. It is not known whether a history of infections can predict benefit from IVIg and can therefore by used to select patients for therapy
Aims
To determine the risk of serious infections when selecting hematological patients for IVIg based on a history of infections and IgG levels.
Methods
A retrospective review of the rate of hospitalisation for infections before and during IVIg therapy in hematological malignancy patients selected for therapy on the basis of serious or recurrent infections was conducted. Results were compared with hypogammaglobulinemic haematology patients not selected for therapy. Characteristics of the groups were compared with Chi-squared tests and event rates expressed as rate ratios with estimated variance to determine 95% confidence limits.
Results
A total of 35 treated patients were treated with IVIg for 1194 months and had 776 months of observations prior to starting treatment. By comparison 57 patients with low IgG levels were identified with hypogammaglobulinemia (IgG<7g/L) who did not require IVIg, with the total observational period being 2587 months. The untreated group had fewer cases with severe hypogammaglobulinemia (51% v 77%, p<0.01) but were otherwise similarly matched for diagnosis, age and sex.
The treated group showed a rate of hospitalisation for bacterial infection of 0.42 per patient year prior to treatment, reducing to 0.14 (relative risk 3.1 (1.6-5.9) for infection prior to treatment). The risk of infection prior to treatment also compared favourably to the 0.08 hospitalisation per patient year in those never treated (relative risk 5.5 (3.0-10)). An IgG level of <4g/L did not predict rates of infection compared with an IgG level >4g/L in either the untreated group or the treated group prior to the commencement of IVIg.
Summary
In this retrospective study, selecting hypogammaglobulinemic hematology patients to have IVIg given or withheld on the basis of a history of infections appears safe and effective.
Keyword(s): Infection, Intravenous gamma-globulin
Session topic: Publication Only