Antunović P
Institute of Haematology, University Clinical Centre, Belgrade.
Srp Arh Celok Lek. 1993 Aug-Dec;121(8-12):155-7.
Abnormalities in serum immunoglobulin levels or in antibody production may develop as a result of many different diseases. Antibody deficiency may occur in previously normal persons with haematologic malignancies or who received immunosuppressive agents in treatment of cancer or in anticipation of bone marrow transplantation. Effective regimens may develop in primary immunodeficiencies and secondary immunodeficiencies as well as in idiopathic thrombocytopenic purpura. Some reports and information about the other haematological indications were published in medical literature. However, the consensus conference on IVIG at the National Institutes of Health (Bethesda--May 21, 1990) recommended treatment with IVIG in haematology only for CLL, ITP and after bone marrow transplantation, as a prevention for GVHD. The adverse effects of IVIG therapy are minimal, but they exist. The other important subject is the cost of widespread use of IVIG; therefore the indications must be carefully concerned and documented before therapy is started.
血清免疫球蛋白水平异常或抗体产生异常可能由多种不同疾病引起。抗体缺乏可能发生在既往正常但患有血液系统恶性肿瘤的患者,或在癌症治疗中接受免疫抑制剂治疗或预期进行骨髓移植的患者身上。有效的治疗方案可能出现在原发性免疫缺陷、继发性免疫缺陷以及特发性血小板减少性紫癜中。医学文献中发表了一些关于其他血液学指征的报告和信息。然而,美国国立卫生研究院(贝塞斯达——1990年5月21日)关于静脉注射免疫球蛋白(IVIG)的共识会议建议,在血液学领域,IVIG仅用于慢性淋巴细胞白血病(CLL)、特发性血小板减少性紫癜(ITP)以及骨髓移植后,作为预防移植物抗宿主病(GVHD)的治疗方法。IVIG治疗的不良反应极小,但确实存在。另一个重要问题是IVIG广泛使用的成本;因此,在开始治疗前必须仔细关注并记录适应证。