Immunoglobulin prophylaxis in chronic lymphocytic leukemia and multiple myeloma: Systematic review and meta-analysis

Pia Raanani, Anat Gafter-Gvili, Mical Paul, Isaac Ben-Bassat, Leonard Leibovici, Ofer Shpilberg

Research output: Contribution to journalArticlepeer-review

Abstract

The role of intravenous immunoglobulins (IVIG) prophylaxis in hypogammaglobulinemic patients with lymphoproliferative disorders (LPD) and plasma cell dyscrasias (PCD) has not been established. We performed a systematic review and meta-analysis of randomized-controlled trials comparing prophylaxis with polyvalent IVIG versus control. The primary outcomes were all-cause mortality and major infections. Nine trials, assessing patients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM), were included. No survival benefit could be demonstrated, RR 1.36 (95% CI 0.58-3.19, two trials), but there was a significant decrease in the occurrence of major infections, RR 0.45 (95% CI 0.27-0.75, three trials) and a significant reduction in clinically documented infections, RR 0.49 (95% CI 0.39-0.61, three trials). Adverse events, usually not requiring discontinuation of IVIG, occurred significantly more with IVIG. On the basis of the available data, IVIG cannot be recommended routinely for patients with CLL or MM with hypogammaglobulinemia and/or recurrent infections and should be considered on individual basis.

Original languageEnglish
Pages (from-to)764-772
Number of pages9
JournalLeukemia and Lymphoma
Volume50
Issue number5
DOIs
StatePublished - 2009

Keywords

  • Chronic lymphocytic leukemia
  • Immunoglobulin prophylaxis
  • Lymphoproliferative disorders
  • Multiple myeloma
  • Plasma cell disorders

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