Prevalence of hypogammaglobulinemia and its management with subcutaneous immunoglobulin supplementation in patients after allogeneic hematopoietic stem cell transplantation—a single-center analysis
Secondary immunodeficiencies are frequently observed after allo-HSCT. The efficacy of subcutaneous IgG preparations in this population is unknown. A retrospective single-institution study involved 126 adult patients transplanted in 2012–2019 for hematological malignancies. Patients were tested every...
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| Veröffentlicht in: | Annals of hematology 2021-12, Vol.100 (12), p.3007-3016 |
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| creator | Karakulska-Prystupiuk, Ewa Dwilewicz-Trojaczek, Jadwiga Drozd-Sokołowska, Joanna Kmin, Ewelina Chlebus, Marcin Szczypińska, Karolina Boguradzki, Piotr Tomaszewska, Agnieszka Mądry, Krzysztof Biliński, Jarosław Basak, Grzegorz Władysław Jędrzejczak, Wiesław Wiktor |
| description | Secondary immunodeficiencies are frequently observed after allo-HSCT. The efficacy of subcutaneous IgG preparations in this population is unknown. A retrospective single-institution study involved 126 adult patients transplanted in 2012–2019 for hematological malignancies. Patients were tested every 2–3 weeks for plasma IgG concentration during the 1st year after transplantation and supplemented with facilitated subcutaneous immunoglobulin when they either had IgG concentration |
| doi_str_mv | 10.1007/s00277-021-04649-y |
| format | Article |
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p
= 0.000) and the systemic use of corticosteroids (64.2% versus 31.5% for patients without systemic corticosteroids,
p
= 0.005). Over 40% of the adult recipients may require at least incidental immunoglobulin supplementation during the first year after allo-HSCT. Low IgG concentrations are associated with inferior outcomes. The subcutaneous route of IgG administration appeared to be safe and may allow for long persistence.</description><identifier>ISSN: 0939-5555</identifier><identifier>EISSN: 1432-0584</identifier><identifier>DOI: 10.1007/s00277-021-04649-y</identifier><identifier>PMID: 34477951</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Administration, Cutaneous ; Adult ; Agammaglobulinemia - blood ; Agammaglobulinemia - etiology ; Agammaglobulinemia - therapy ; Disease Management ; Female ; Hematologic Neoplasms - therapy ; Hematology ; Hematopoietic Stem Cell Transplantation - adverse effects ; Humans ; Immunoglobulins ; Immunoglobulins - administration & dosage ; Immunoglobulins - blood ; Immunoglobulins - therapeutic use ; Leukemia ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Oncology ; Original ; Original Article ; Prevalence ; Retrospective Studies ; Steroids ; Transplantation, Homologous - adverse effects ; Young Adult</subject><ispartof>Annals of hematology, 2021-12, Vol.100 (12), p.3007-3016</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-acc17ceb6dbf5f53057919f7a63c37d2ac09bac58dbb346cd39e0010da7fa4da3</citedby><cites>FETCH-LOGICAL-c474t-acc17ceb6dbf5f53057919f7a63c37d2ac09bac58dbb346cd39e0010da7fa4da3</cites><orcidid>0000-0002-0201-5041</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00277-021-04649-y$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00277-021-04649-y$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34477951$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karakulska-Prystupiuk, Ewa</creatorcontrib><creatorcontrib>Dwilewicz-Trojaczek, Jadwiga</creatorcontrib><creatorcontrib>Drozd-Sokołowska, Joanna</creatorcontrib><creatorcontrib>Kmin, Ewelina</creatorcontrib><creatorcontrib>Chlebus, Marcin</creatorcontrib><creatorcontrib>Szczypińska, Karolina</creatorcontrib><creatorcontrib>Boguradzki, Piotr</creatorcontrib><creatorcontrib>Tomaszewska, Agnieszka</creatorcontrib><creatorcontrib>Mądry, Krzysztof</creatorcontrib><creatorcontrib>Biliński, Jarosław</creatorcontrib><creatorcontrib>Basak, Grzegorz Władysław</creatorcontrib><creatorcontrib>Jędrzejczak, Wiesław Wiktor</creatorcontrib><title>Prevalence of hypogammaglobulinemia and its management with subcutaneous immunoglobulin supplementation in patients after allogeneic hematopoietic stem cell transplantation—a single-center analysis</title><title>Annals of hematology</title><addtitle>Ann Hematol</addtitle><addtitle>Ann Hematol</addtitle><description>Secondary immunodeficiencies are frequently observed after allo-HSCT. The efficacy of subcutaneous IgG preparations in this population is unknown. A retrospective single-institution study involved 126 adult patients transplanted in 2012–2019 for hematological malignancies. Patients were tested every 2–3 weeks for plasma IgG concentration during the 1st year after transplantation and supplemented with facilitated subcutaneous immunoglobulin when they either had IgG concentration < 500 mg/dl or between 500 and 700 mg/dl and recurrent infection. The IgG concentration < 500 mg/dL was diagnosed in 41 patients, while 500–700 mg/dL in 25 and altogether 53 patients received IgG supplementation. The median number of IgG administrations was 2. The median time to the first IgG administration after allo-HSCT was 4.1 months, while to the next administration (if more than one was required) 53 days (prophylactic group) and 32 days (group with infections). We did not observe any significant toxicity. Two situations were associated with increased probability of meeting criteria for IgG supplementation: diagnosis of either acute lymphoblastic leukemia (ALL) or chronic lymphocytic leukemia (CLL) (83.8% versus 39.3% for other diagnosis,
p
= 0.000) and the systemic use of corticosteroids (64.2% versus 31.5% for patients without systemic corticosteroids,
p
= 0.005). Over 40% of the adult recipients may require at least incidental immunoglobulin supplementation during the first year after allo-HSCT. Low IgG concentrations are associated with inferior outcomes. The subcutaneous route of IgG administration appeared to be safe and may allow for long persistence.</description><subject>Administration, Cutaneous</subject><subject>Adult</subject><subject>Agammaglobulinemia - blood</subject><subject>Agammaglobulinemia - etiology</subject><subject>Agammaglobulinemia - therapy</subject><subject>Disease Management</subject><subject>Female</subject><subject>Hematologic Neoplasms - therapy</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation - adverse effects</subject><subject>Humans</subject><subject>Immunoglobulins</subject><subject>Immunoglobulins - administration & dosage</subject><subject>Immunoglobulins - blood</subject><subject>Immunoglobulins - therapeutic use</subject><subject>Leukemia</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Original</subject><subject>Original Article</subject><subject>Prevalence</subject><subject>Retrospective Studies</subject><subject>Steroids</subject><subject>Transplantation, Homologous - 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The efficacy of subcutaneous IgG preparations in this population is unknown. A retrospective single-institution study involved 126 adult patients transplanted in 2012–2019 for hematological malignancies. Patients were tested every 2–3 weeks for plasma IgG concentration during the 1st year after transplantation and supplemented with facilitated subcutaneous immunoglobulin when they either had IgG concentration < 500 mg/dl or between 500 and 700 mg/dl and recurrent infection. The IgG concentration < 500 mg/dL was diagnosed in 41 patients, while 500–700 mg/dL in 25 and altogether 53 patients received IgG supplementation. The median number of IgG administrations was 2. The median time to the first IgG administration after allo-HSCT was 4.1 months, while to the next administration (if more than one was required) 53 days (prophylactic group) and 32 days (group with infections). We did not observe any significant toxicity. Two situations were associated with increased probability of meeting criteria for IgG supplementation: diagnosis of either acute lymphoblastic leukemia (ALL) or chronic lymphocytic leukemia (CLL) (83.8% versus 39.3% for other diagnosis,
p
= 0.000) and the systemic use of corticosteroids (64.2% versus 31.5% for patients without systemic corticosteroids,
p
= 0.005). Over 40% of the adult recipients may require at least incidental immunoglobulin supplementation during the first year after allo-HSCT. Low IgG concentrations are associated with inferior outcomes. The subcutaneous route of IgG administration appeared to be safe and may allow for long persistence.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34477951</pmid><doi>10.1007/s00277-021-04649-y</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-0201-5041</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Annals of hematology, 2021-12, Vol.100 (12), p.3007-3016 |
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| subjects | Administration, Cutaneous Adult Agammaglobulinemia - blood Agammaglobulinemia - etiology Agammaglobulinemia - therapy Disease Management Female Hematologic Neoplasms - therapy Hematology Hematopoietic Stem Cell Transplantation - adverse effects Humans Immunoglobulins Immunoglobulins - administration & dosage Immunoglobulins - blood Immunoglobulins - therapeutic use Leukemia Male Medicine Medicine & Public Health Middle Aged Oncology Original Original Article Prevalence Retrospective Studies Steroids Transplantation, Homologous - adverse effects Young Adult |
| title | Prevalence of hypogammaglobulinemia and its management with subcutaneous immunoglobulin supplementation in patients after allogeneic hematopoietic stem cell transplantation—a single-center analysis |
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