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静脉注射免疫球蛋白预防与多发性骨髓瘤患者感染相关住院率降低有关。

Intravenous immunoglobulin prophylaxis is associated with decreased rate of infection-related hospitalizations in multiple myeloma patients.

作者信息

Sheu Michael, Molina Garcia Sofia, Patel Meera, Granat Lauren, Williams Louis, Khouri Jack, Mossad Sherif, Anwer Faiz, Majeed Aneela

机构信息

Cleveland Clinic, Internal Medicine, Cleveland, Ohio, USA.

Cleveland Clinic, Hematology and Medical Oncology, Cleveland, Ohio, USA.

出版信息

Hematol Oncol. 2023 Oct;41(4):718-724. doi: 10.1002/hon.3185. Epub 2023 May 25.

Abstract

This study explored the efficacy of intravenous immunoglobulin (IVIG) prophylaxis in reducing infection-related hospitalizations (IRHs) in MM patients. This was a retrospective study of MM patients who received IVIG at Taussig Cancer Center between July 2009 and July 2021. The primary endpoint was rate of IRHs per patient-year on-IVIG versus off-IVIG. 108 patients were included. There was a significant difference in the primary endpoint of rate of IRHs per patient-year on-IVIG versus off-IVIG in the overall study population (0.81 vs. 1.08; Mean Difference [MD], -0.27; 95% Confidence Interval [CI], -0.57 to 0.03; p value [P] = 0.04). The subgroup of patients with a 1-year period of continuous IVIG (49, 45.3%), the subgroup with standard-risk cytogenetics (54, 50.0%) and the subgroup with 2 or more IRHs (67, 62.0%) all showed a significant reduction in IRHs while on-IVIG versus off-IVIG (0.48 vs. 0.78; MD, -0.30; 95% CI, -0.59 to 0.002; p = 0.03) and (0.65 vs. 1.01; MD, -0.36; 95% CI, -0.71 to -0.01; p = 0.02) and (1.04 vs. 1.43; MD, -0.39; 95% CI, -0.82 to 0.05; p = 0.04) respectively. IVIG showed significant benefit in reducing IRHs in the overall population and in multiple subgroups.

摘要

本研究探讨了静脉注射免疫球蛋白(IVIG)预防在减少多发性骨髓瘤(MM)患者感染相关住院(IRH)方面的疗效。这是一项回顾性研究,纳入了 2009 年 7 月至 2021 年 7 月期间在陶西格癌症中心接受 IVIG 治疗的 MM 患者。主要终点是 IVIG 治疗组与 IVIG 停药组患者每年每例感染相关住院率(IRH)。共纳入 108 例患者。总体研究人群中 IVIG 治疗组与 IVIG 停药组患者每年每例感染相关住院率(IRH)的主要终点存在显著差异(0.81 比 1.08;均数差值[MD],-0.27;95%置信区间[CI],-0.57 至 0.03;P 值[P] = 0.04)。在接受为期 1 年连续 IVIG 治疗的患者亚组(49 例,45.3%)、具有标准风险细胞遗传学的患者亚组(54 例,50.0%)和具有 2 次或以上 IRH 的患者亚组(67 例,62.0%)中,与 IVIG 停药组相比,IVIG 治疗组的 IRH 发生率均显著降低(0.48 比 0.78;MD,-0.30;95%CI,-0.59 至 0.002;P = 0.03)和(0.65 比 1.01;MD,-0.36;95%CI,-0.71 至 -0.01;P = 0.02)和(1.04 比 1.43;MD,-0.39;95%CI,-0.82 至 0.05;P = 0.04)。IVIG 在总体人群和多个亚组中均显示出降低 IRH 的显著获益。

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