A Retrospective Study on the Efficacy of Subcutaneous Immunoglobulin as Compared to Intravenous Formulation in Patients with Chronic Lymphocytic Leukemia and Secondary Antibody Deficiency.
chronic lymphocytic leukemia
intravenous immunoglobulin
replacement therapy
secondary immunodeficiency
subcutaneous immunoglobulin
Journal
Current oncology (Toronto, Ont.)
ISSN: 1718-7729
Titre abrégé: Curr Oncol
Pays: Switzerland
ID NLM: 9502503
Informations de publication
Date de publication:
25 12 2022
25 12 2022
Historique:
received:
08
11
2022
revised:
11
12
2022
accepted:
21
12
2022
entrez:
20
1
2023
pubmed:
21
1
2023
medline:
25
1
2023
Statut:
epublish
Résumé
Secondary antibody deficiency (SAD) is a common complication in chronic lymphocytic leukemia (CLL) which favors the development of life-threatening infections. Subcutaneous immunoglobulins (IG) (SCIG) have been proven to be as effective as intravenous immunoglobulin (IVIG) in primary immunodeficiencies. Since only a few studies investigated SCIG in secondary antibody deficiency, the aim of this study was to assess the efficacy and safety of SCIG or IVIG in CLL patients with secondary antibody deficiency. One hundred and sixteen CLL patients were recruited, 63% were males, and the median age was 68 years; 44% had bronchiectasis and 76% never smoked. Forty-nine patients received IVIG and 88 SCIG, including 28 patients who shifted from IVIG to SCIG. Despite similar baseline IgG levels, patients receiving SCIG achieved higher IgG after at least +6 months (p = 0.0009). We observed that SCIG can decrease the cumulative incidence of first (HR 0.39 p < 0.0001) and second (HR 0.56 p = 0.0411) infection more than IVIG. The effect was remarkable in that patients were able to reach at least 6 g/L of IgG after 6 months of treatments (p < 0.0001). Replacement therapies were well tolerated with less adverse events and a lower discontinuation rate in patients was managed with SCIG than IVIG. In this study we describe the clinical features of a large cohort of CLL with secondary antibody deficiency receiving IG. We demonstrated that SCIG are active and well tolerated drugs that allows to reach higher IgG levels and decrease the rate of infections better than IVIG, in particular when IgG levels reach 6 g/L.
Identifiants
pubmed: 36661671
pii: curroncol30010022
doi: 10.3390/curroncol30010022
pmc: PMC9857433
doi:
Substances chimiques
Immunoglobulins, Intravenous
0
Immunoglobulin G
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
274-283Références
Front Immunol. 2020 Nov 18;11:594556
pubmed: 33312177
Cancer Med. 2021 Nov;10(21):7629-7640
pubmed: 34558211
Haematologica. 1996 Mar-Apr;81(2):121-6
pubmed: 8641639
Br J Haematol. 2019 Apr;185(1):193-197
pubmed: 29974955
Blood Adv. 2022 Jan 11;6(1):148-151
pubmed: 34614513
N Engl J Med. 1988 Oct 6;319(14):902-7
pubmed: 2901668
Br J Haematol. 2022 Oct;199(1):54-60
pubmed: 35906881
Haematologica. 2022 Apr 01;107(4):868-876
pubmed: 34092056
Br J Cancer. 2019 Jul;121(2):150-156
pubmed: 31209327
J Natl Compr Canc Netw. 2022 Jun;20(6):622-634
pubmed: 35714675
Leuk Res. 2017 Jun;57:65-71
pubmed: 28292720
Hematology. 2019 Dec;24(1):173-182
pubmed: 30458690
Immunotherapy. 2022 Feb;14(2):135-143
pubmed: 34743590
Eur J Cancer. 2017 Feb;72:103-111
pubmed: 28027513
Am J Hematol. 2022 Mar 1;97(3):E95-E99
pubmed: 34904743
Int J Immunopathol Pharmacol. 2017 Mar;30(1):73-82
pubmed: 27927705
Am J Hematol. 2021 Dec 1;96(12):1679-1705
pubmed: 34625994
Haematologica. 2015 Dec;100(12):e515-8
pubmed: 26294735
Nat Rev Dis Primers. 2017 Jan 19;3:16096
pubmed: 28102226
J Clin Med. 2022 Apr 07;11(8):
pubmed: 35456167
Anticancer Res. 2018 Jul;38(7):4187-4191
pubmed: 29970548
Hematol Oncol. 2022 Aug;40(3):469-474
pubmed: 35076123
Leukemia. 2012 Jul;26(7):1458-61
pubmed: 22297721
Clin Exp Immunol. 2015 Dec;182(3):302-13
pubmed: 26288095
Br J Haematol. 2018 Apr;181(2):229-233
pubmed: 29611195
Br J Haematol. 2021 Apr;193(2):316-324
pubmed: 33058237
Leuk Lymphoma. 2022 Aug;63(8):1985-1988
pubmed: 35343363
Leukemia. 2021 Dec;35(12):3444-3454
pubmed: 34725454
Blood. 2015 Jul 30;126(5):573-81
pubmed: 26084672
Blood. 2021 Mar 11;137(10):1365-1376
pubmed: 32992344
Cancers (Basel). 2021 Jun 29;13(13):
pubmed: 34209515
Hematol Oncol. 2017 Dec;35(4):925-928
pubmed: 27641225
Leukemia. 2022 Aug;36(8):1961-1968
pubmed: 35614318
N Engl J Med. 1991 Jul 11;325(2):81-6
pubmed: 1904989
J Hematol Oncol. 2022 Aug 26;15(1):116
pubmed: 36028857
PLoS One. 2021 Mar 4;16(3):e0247717
pubmed: 33661940
Leukemia. 2021 Mar;35(3):737-746
pubmed: 32555297