Full article in Open-access

 

Benbrahim O1Viallard JF2Choquet S3Royer B4Bauduer F5Decaux O6Crave JC7Fardini Y8Clerson P8Levy V9.

ABSTRACT:

OBJECTIVE:
To describe the characteristics of patients suffering from secondary immunodeficiencies (SID) associated with hematological malignancies (HM), who started immunoglobulins replacement therapy (IgRT), physicians’ expectations regarding IgRT and IgRT 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), 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 5% an allograft. Serum immunoglobulins trough levels in 195 individuals were less than 5g/L in 68.7% of cases. Most patients had a history of recurrent infections. Immunoglobulin dose was about 400 mg/kg/month. Half of patients started with subcutaneous infusion. When starting IgRT, 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 IgRT besides well recognized indications. Physicians mainly based the decision of starting IgRT on hypogammaglobulinemia and recurrence of infections but, irrespective of current recommendations, were also prepared to start IgRT prophylactically even in the absence of a history of infections.

KEYWORDS:
Evidence-Based Medicine; Hematologic malignancies; Immunoglobulins; Intravenous Infusions; hypogammaglobulinemia; secondary immunodeficiency; subcutaneous Infusions

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