Winston D J, Ho W G, Lin G H, Bartoni K, Budinger M D, Gale R P, Champlin R E
Immun Infekt. 1985 Nov;13(6):296-301.
The effects of prophylactic, polyvalent intravenous immune globulin on cytomegalovirus infection and interstitial pneumonia in allogenic marrow transplants were evaluated in an ongoing, randomized controlled trial. Thirty-eight patients were given weekly doses (20 cc/kg) of polyvalent intravenous immune globulin before and after transplantation, and 37 patients were controls. Both symptomatic cytomegalovirus infection (17 of 37 or 46% vs. 8 of 38 or 21%, p = 0.04) and interstitial pneumonia (17 of 37 or 46% vs. 7 of 38 or 18%, p = 0.02) occurred less frequently in the recipients of polyvalent intravenous immune globulin. In separate kinetic studies, a 5 cc/kg dose of a cytomegalovirus-specific hyperimmune globulin produced cytomegalovirus antibody titers in patients equivalent to those achieved after the 20 cc/kg dose of polyvalent intravenous immune globulin. All immune globulin preparations were well-tolerated. These preliminary results suggest that intravenous immune globulin can modify the severity of cytomegalovirus infection and prevent interstitial pneumonia in marrow transplants. Additional trials are now needed to define the minimal effective dose of intravenous immune globulin and to compare the effectiveness of different intravenous immune globulin formulations.
在一项正在进行的随机对照试验中，评估了预防性多价静脉注射免疫球蛋白对异基因骨髓移植中巨细胞病毒感染和间质性肺炎的影响。38例患者在移植前后每周接受多价静脉注射免疫球蛋白（20 cc/kg），37例患者作为对照。接受多价静脉注射免疫球蛋白的患者中，有症状的巨细胞病毒感染（37例中的17例，占46%，而38例中的8例，占21%，p = 0.04）和间质性肺炎（37例中的17例，占46%，而38例中的7例，占18%，p = 0.02）的发生率均较低。在单独的动力学研究中，5 cc/kg剂量的巨细胞病毒特异性超免疫球蛋白在患者中产生的巨细胞病毒抗体滴度与20 cc/kg剂量的多价静脉注射免疫球蛋白所达到的滴度相当。所有免疫球蛋白制剂耐受性良好。这些初步结果表明，静脉注射免疫球蛋白可以改变巨细胞病毒感染的严重程度，并预防骨髓移植中的间质性肺炎。现在需要进行更多试验来确定静脉注射免疫球蛋白的最小有效剂量，并比较不同静脉注射免疫球蛋白制剂的有效性。
