Boughton B J, Jackson N, Lim S, Smith N
Department of Haematology, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
Clin Lab Haematol. 1995 Mar;17(1):75-80. doi: 10.1111/j.1365-2257.1995.tb00322.x.
Forty-two patients with chronic lymphocytic leukaemia (CLL), serum IgG levels < 5.5 milligrams and a history of two or more recent infections, were randomized to receive infusions of 18 g human intravenous immunoglobulin (IVIg) or human albumin placebo every three weeks. During the 12 month study 122 infections were documented but only four were associated with neutropenia. Ten patients (24%) with IgG levels < 3.0 milligrams experienced 65% of the infections. In response to IVIg there were immediate and accumulative increases in serum IgG levels and an associated decrease in total and serious infections. If three further infections occurred, placebo patients were commenced on 18 g IVIg, and IVIg patients were increased to 24 g IVIg. Approximately 50% of these cases subsequently remained infection free. The study shows the usefulness of prophylactic Sandoglobulin in CLL patients with hypogammaglobulinaemia, and suggests that this may be justified in those with recurrent infections and serum IgG levels < 3 milligrams.
42例慢性淋巴细胞白血病（CLL）患者，血清IgG水平低于5.5毫克，且近期有两次或更多次感染史，被随机分为两组，分别每三周接受18克人静脉注射免疫球蛋白（IVIg）或人白蛋白安慰剂输注。在为期12个月的研究中，记录到122次感染，但只有4次与中性粒细胞减少有关。10例IgG水平低于3.0毫克的患者（24%）经历了65%的感染。静脉注射免疫球蛋白治疗后，血清IgG水平立即升高且呈累积性增加，同时总的和严重的感染次数减少。如果再发生三次感染，安慰剂组患者开始接受18克静脉注射免疫球蛋白治疗，静脉注射免疫球蛋白组患者剂量增加至24克。这些病例中约50%随后未再发生感染。该研究表明，预防性使用沙格司亭对低丙种球蛋白血症的CLL患者有用，并且提示对于反复感染且血清IgG水平低于3毫克的患者，这样做可能是合理的。
