A Canadian perspective on the use of immunoglobulin therapy to reduce infectious complications in chronic lymphocytic leukemia.
Curr Oncol. 2016 Feb;23(1):42-51. doi: 10.3747/co.23.2810. Epub 2016 Feb 18.
Lachance S1, Christofides AL2, Lee JK3, Sehn LH4, Ritchie BC5, Shustik C6, Stewart DA7, Toze CL8, Haddad E9, Vinh DC6.
1Université de Montréal, Montreal, QC;
2New Evidence, Toronto, ON;
3Canadian Society of Allergy and Clinical Immunology, Toronto, ON;
4BC Cancer Agency, Vancouver, BC;
5University of Alberta, Edmonton, AB;
6McGill University Health Centre, Montreal, QC;
7Tom Baker Cancer Centre, Calgary, AB;
8Leukemia/Bone Marrow Transplant Program of BC, Vancouver General Hospital, BC Cancer Agency, and University of British Columbia, Vancouver, BC;
9chu Sainte-Justine, Departments of Pediatrics and of Microbiology, Immunology, and Infectiology, Université de Montréal, Montreal, QC.
Infections are a major cause of morbidity and mortality in patients with chronic lymphocytic leukemia (cll), who typically have increased susceptibility because of hypogammaglobulinemia (hgg) related to their disease and its treatment. Immunoglobulin replacement therapy (igrt) has been shown to reduce the frequency of bacterial infections and associated hospitalizations in patients with hgg or a history of infection, or both. However, use of igrt in cll is contentious. Studies examining such treatment were conducted largely before the use of newer chemoimmunotherapies, which can extend lifespan, but do not correct the hgg inherent to the disease. Thus, the utility of igrt has to be re-evaluated in the current setting. Here, we discuss the evidence for the use of igrt in cll and provide a practical approach to its use in the prevention and management of infections.
Entry filed under: Bacterias, Bacteriemias, Biología Molecular, Epidemiología, F.O.D, Health Care-Associated Infections, Infecciones en neutropenicos, Infecciones en onco-hematologicos, Metodos diagnosticos, Sepsis.