Intravenous immunoglobulin for the prevention of infection in chronic lymphocytic leukemia. A randomized, controlled clinical trial. Cooperative Group for the Study of Immunoglobulin in Chronic Lymphocytic Leukemia
In a double-blind study, we randomly assigned 84 patients with chronic lymphocytic leukemia who were judged to be at increased risk of bacterial infection to receive intravenous immunoglobulin G (400 mg per kilogram of body weight) or a placebo every three weeks for one year. Eligible patients had hypogammaglobulinemia, a history of infection, or both. The patients receiving immunoglobulin had significantly fewer bacterial infections during the study period than those receiving placebo (23 vs. 42; P = 0.01). This reduction was most striking in the patients who completed a full year of treatment (14 vs. 36; P = 0.001). The period from study entry to the first serious bacterial infection was significantly longer in the patients receiving immunoglobulin (P = 0.026). There was no significant difference between the two groups in the incidence of nonbacterial infection. Immunoglobulin therapy was tolerated well; there were no serious adverse reactions, and the incidence of minor reactions was low. We conclude that selected patients with chronic lymphocytic leukemia who are at risk of bacterial infection can be substantially protected from this complication by the regular intravenous administration of immunoglobulin.
This article has been cited by other articles:
Raanani, P., Gafter-Gvili, A., Paul, M., Ben-Bassat, I., Leibovici, L., Shpilberg, O.
(2009). Immunoglobulin Prophylaxis in Hematopoietic Stem Cell Transplantation: Systematic Review and Meta-Analysis. JCO
27: 770-781
[Abstract][Full Text]
Dearden, C.
(2008). Disease-Specific Complications of Chronic Lymphocytic Leukemia. ASH Education Book
2008: 450-456
[Abstract][Full Text]
Shanafelt, T. D., Kay, N. E.
(2007). Comprehensive Management of the CLL Patient: A Holistic Approach. ASH Education Book
2007: 324-331
[Abstract][Full Text]
Morrison, V. A.
(2007). Management of Infectious Complications in Patients with Chronic Lymphocytic Leukemia. ASH Education Book
2007: 332-338
[Abstract][Full Text]
Shanafelt, T. D., Byrd, J. C., Call, T. G., Zent, C. S., Kay, N. E.
(2006). Narrative review: initial management of newly diagnosed, early-stage chronic lymphocytic leukemia.. ANN INTERN MED
145: 435-447
[Abstract][Full Text]
Yee, K. W. L., O'Brien, S. M.
(2006). Chronic Lymphocytic Leukemia: Diagnosis and Treatment. Mayo Clin Proc.
81: 1105-1129
[Abstract][Full Text]
Lawrence, C., Ellman, L., Hirsch, M., Hollander, H.
(2005). Case 22-2005: intravenous immune globulin in chronic lymphocytic leukemia.. NEJM
353: 1862-1863
[Full Text]
Brannagan, T. H. III
(2002). Intravenous gammaglobulin (IVIg) for treatment of CIDP and related immune-mediated neuropathies. Neurology
59: S33-40
[Abstract][Full Text]
Mauro, F. R., Foa, R., Cerretti, R., Giannarelli, D., Coluzzi, S., Mandelli, F., Girelli, G.
(2000). Autoimmune hemolytic anemia in chronic lymphocytic leukemia: clinical, therapeutic, and prognostic features. Blood
95: 2786-2792
[Abstract][Full Text]
Kalil, N., Cheson, B. D.
(1999). Chronic Lymphocytic Leukemia. The Oncologist
4: 352-369
[Abstract][Full Text]
Gowda, R, Razvi, F M, Summerfield, G P
(1995). Risk of pneumococcal septicaemia in patients with chronic lymphoproliferative malignancies. BMJ
311: 26-27
[Full Text]
Janoff, E. N., Breiman, R. F., Daley, C. L., Hopewell, P. C.
(1992). Pneumococcal Disease during HIV Infection: Epidemiologic, Clinical, and Immunologic Perspectives. ANN INTERN MED
117: 314-324
[Abstract]
Schneider, R. P., Christou, N. V., Nohr, C.
(1992). Abnormal In Vitro Immunoglobulin Synthesis in Surgical Patients. Arch Surg
127: 198-205
[Abstract]
Foon, K. A., Rai, K. R., Gale, R. P.
(1990). Chronic Lymphocytic Leukemia: New Insights into Biology and Therapy. ANN INTERN MED
113: 525-539
[Abstract]
Berkman, S. A., Lee, M. L., Gale, R. P.
(1990). Clinical Uses of Intravenous Immunoglobulins. ANN INTERN MED
112: 278-292
[Abstract]
(1988). IV IMMUNOGLOBULIN REDUCES INFECTION IN PATIENTS WITH CLL. JWatch General
1988: 5-5
[Full Text]