Cleveland Clinic, Internal Medicine, Cleveland, Ohio, USA.
Cleveland Clinic, Hematology and Medical Oncology, Cleveland, Ohio, USA.
Hematol Oncol. 2023 Oct;41(4):718-724. doi: 10.1002/hon.3185. Epub 2023 May 25.
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.
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。
