Lachance S, Christofides A L, Lee J K, Sehn L H, Ritchie B C, Shustik C, Stewart D A, Toze C L, Haddad E, Vinh D C
Université de Montréal, Montreal, QC;
New Evidence, Toronto, ON;
Curr Oncol. 2016 Feb;23(1):42-51. doi: 10.3747/co.23.2810. Epub 2016 Feb 18.
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.
感染是慢性淋巴细胞白血病（CLL）患者发病和死亡的主要原因，由于与疾病及其治疗相关的低丙种球蛋白血症（HGG），这些患者通常易感性增加。免疫球蛋白替代疗法（IGRT）已被证明可降低HGG患者或有感染史或两者兼有的患者的细菌感染频率及相关住院率。然而，在CLL中使用IGRT存在争议。研究这种治疗方法的研究大多是在使用新型化疗免疫疗法之前进行的，新型化疗免疫疗法可以延长生存期，但不能纠正该疾病固有的HGG。因此，在当前情况下必须重新评估IGRT的效用。在此，我们讨论在CLL中使用IGRT的证据，并提供在预防和管理感染中使用IGRT的实用方法。
