Treatment of fever and neutropenia with antibiotics versus antibiotics plus intravenous gammaglobulin in childhood leukemia

Sumer, Timur; Abu-Melha, Abdullah; Al-Mulhim, Ibrahim; Al‐Fadil, M.

doi:10.1007/bf00595896

Cited by 12 publications

(5 citation statements)

References 12 publications

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“…К концу 1980-х годов этот метод стал широко распространенным и зарекомендовал себя как один из наиболее эффективных и безопасных [7]. Применение ВВИГ при ИТП послужило поводом к более активному применению данной группы препаратов в гематологии-онкологии и при ТГСК -был выпущен ряд работ, демонстрирующих эффективность у пациентов с нейтропениями и другими осложнениями при остром лимфобластном лейкозе и при ТГСК [8][9]. Так, например, было показано, что профилактическое применение ВВИГ в дозе 0,5 г/кг массы тела пациента значимо снижало риски развития острой реакции «трансплантат против хозяина», интерстициальной пневмонии и других инфекций.…”

Section: томunclassified

Therapy with intravenous immunoglobulins in pediatric hematology-oncology and transplantation of hematopoietic stem cells

Киргизов¹

2018

Ross. ž. det. gematol. onkol.

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В обзоре литературы представлены основные сведения по использованию препаратов внутривенных иммуноглобулинов (ВВИГ) в детской гематологии-онкологии и в контексте трансплантации гемопоэтических стволовых клеток в исторической перспективе и на современном этапе. Показаны основные требования к ВВИГ, которые заключаются в использовании безопасных и качественных растворов с высоким содержанием иммуноглобулинов, которые несут минимальные риски для пациентов. Автор представляет основные показания, которые включают патогенетическую терапию аутоиммунных и вирусных заболеваний (осложнений) и заместительную терапию в целях коррекции вторичного иммунодефицита на фоне химио-и таргетной терапии.

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Section: томunclassified

Therapy with intravenous immunoglobulins in pediatric hematology-oncology and transplantation of hematopoietic stem cells

Киргизов¹

2018

Ross. ž. det. gematol. onkol.

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“…It was proposed to systematically replete patients with intravenous immunoglobulins (IVIG) to limit the risk of infection after allo‐HSCT 7,8 . Different substitution regimens were studied with conflicting results 9‐13 . Meta‐analysis concluded that there was no benefit of a systematic substitution of IVIG on the occurrence of infections, infection‐related mortality, and overall mortality 14 …”

Section: Introductionmentioning

confidence: 99%

Risk of infection according to the gamma globulin level in the 100 days following allogeneic stem cell transplantations

Lacombe

Gomes

Thépot

et al. 2021

European J of Haematology

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Background Immunoglobulin replacement therapy is recommended in case of severe hypogammaglobulinemia after allogeneic hematopoietic stem cell transplantation (allo‐HSCT). However, the supposed increased risk of infection in case of hypogammaglobulinemia has not been confirmed in allo‐HSCT. In this study, we assessed the relationship between the gamma globulin level and the risk of infection during the 100 days following the allo‐HSCT. Methods We gathered the weekly laboratory tests from day 7 to day 100 of 76 allograft patients, giving a total of 1 044 tests. 130 infections were documented clinically, by imaging, or microbiologically. Results Average gamma globulin levels between D‐7 and D100 did not differ between patients with or without infection (642 ± 232 and 671 ± 246 mg/dL, respectively, P = .65). Gamma globulin level <400 mg/dl was not associated with the occurrence of infection between the test studied and the next one (aOR 1.33 [0.84‐2.15], P = .24). The gamma globulin level was not predictive of bacterial or fungal infections (AUC 0.54 [95%CI: 0.47‐0.61]) nor of viral reactivations (AUC 0.51 [95%CI: 0.43‐0.60]). Conclusions This confirmed that the humoral deficiency is a minor part of the immune deficiency in the 100 days post‐transplant. This questions the relevance of the indications of immunoglobulin substitution during this period.

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“…17 Additionally, IVIG has been used to augment antibiotic treatment in children with leukemia and fever and neutropenia. Sumer et al 18 randomly assigned 33 children to receive either antibiotics with IVIG or antibiotics without IVIG. They found that the duration of fever in the IVIG group was significantly shorter, although the duration of interruption of chemotherapy and length of hospitalization and neutropenia were not different.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Safety of Intravenous Immunoglobulin Administration During Maintenance Chemotherapy in Children with Acute Lymphoblastic Leukemia in First Complete Remission: A Health Maintenance Organization Perspective

Winkle

Burchette

Kim

et al. 2018

TPJ

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Context: Children with acute lymphoblastic leukemia (ALL) in first complete remission (CR1) experience hypogammaglobulinemia and are at risk of sepsis during maintenance chemotherapy. Intravenous immunoglobulin (IVIG) has been used to try to circumvent this risk, but no data exist regarding its safety and prevalence in a health maintenance organization.Objective: To evaluate the prevalence and safety of IVIG in children with ALL in CR1 during maintenance chemotherapy.Design: A multicenter, retrospective cohort study of consecutive children with ALL in CR1 during maintenance chemotherapy from 2008 to 2014. Groups treated with or without IVIG were compared using nonparametric statistics. Multivariate logistic regression involved all variables available before maintenance therapy began.Results: One hundred eighteen patients were included (53% males), aged 9 months to 19 years. Thirty of 31 patients (97%) who had immunoglobulins analyzed before IVIG were hypogammaglobulinemic. Thirty-six patients (30%) received IVIG during maintenance chemotherapy. Patients received an average of 10.5 IVIG doses (range = 1-31). Ninety-seven percent of doses were administered without a transfusion reaction. Other factors associated with IVIG use were prior double-delayed intensification (odds ratio = 5.36, 95% confidence interval = 1.3-27.49, p = 0.026) and episodes of bacteremia or fungemia before maintenance chemotherapy (odds ratio = 3.04, 95% confidence interval = 1.25-7.51, p = 0.015).Conclusion: Use of IVIG in children with ALL in CR1 with hypogammaglobulinemia occurred in approximately 30% of patients and was well tolerated. Administration of IVIG significantly correlated with a history of double-delayed intensification and prior bacteremia or fungemia.

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Treatment of fever and neutropenia with antibiotics versus antibiotics plus intravenous gammaglobulin in childhood leukemia

Cited by 12 publications

References 12 publications

Therapy with intravenous immunoglobulins in pediatric hematology-oncology and transplantation of hematopoietic stem cells

Therapy with intravenous immunoglobulins in pediatric hematology-oncology and transplantation of hematopoietic stem cells

Risk of infection according to the gamma globulin level in the 100 days following allogeneic stem cell transplantations

Prevalence and Safety of Intravenous Immunoglobulin Administration During Maintenance Chemotherapy in Children with Acute Lymphoblastic Leukemia in First Complete Remission: A Health Maintenance Organization Perspective

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