Buckland, M;
NA, I-K;
(2019)
Current clinical practice and challenges in the management of secondary immunodeficiency in hematological malignancies.
European Journal of Haematology
, 102
(6)
pp. 447-456.
10.1111/ejh.13223.
Preview |
Text
Buckland_Na_et_al-2019-European_Journal_of_Haematology.pdf - Published Version Download (579kB) | Preview |
Abstract
Objective Despite long-standing safe and effective use of immunoglobulin replacement therapy (IgRT) in primary immunodeficiency, clinical data on IgRT in patients with secondary immunodeficiency (SID) due to B- cell lymphoproliferative diseases are limited. Here we examine the correlation between approved IgRT indications, treatment recommendations and clinical practice in SID. Methods An international online survey of 230 physicians responsible for the diagnosis of SID and the prescription of IgRT in patients with hematological malignancies was conducted. Results Serum immunoglobulin was measured in 83% of patients with multiple myeloma, 76% with chronic lymphocytic leukemia and 69% with non-Hodgkin lymphoma. Most physicians (85%) prescribed IgRT after ≥2 severe infections. In Italy, Germany, Spain, and the USA, immunoglobulin use was above average in patients with hypogammaglobulinemia, while in the UK considerably fewer patients received IgRT. The use of subcutaneous immunoglobulin was highest in France (34%) and lowest in Spain (19%). Immunologists measured specific antibody responses, performed test immunization, implemented IgRT and used subcutaneous immunoglobulin more frequently than physicians overall. Conclusions The management of SID in hematological malignancies varied regionally. Clinical practice did not reflect treatment guidelines, highlighting the need for robust clinical studies on IgRT in this population and harmonization between countries and disciplines.
| Type: | Article |
|---|---|
| Title: | Current clinical practice and challenges in the management of secondary immunodeficiency in hematological malignancies |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/ejh.13223 |
| Publisher version: | https://doi.org/10.1111/ejh.13223 |
| Language: | English |
| Additional information: | © 2019 The Authors. European Journal of Haematology Published by John Wiley & Sons Ltd This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
| Keywords: | secondary immunodeficiency, immunoglobulins, SCIG, IVIG, infection, hematological disorders, multiple myeloma, chronic lymphocytic leukemia, non-Hodgkin lymphoma, international survey |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10069432 |
Archive Staff Only
 |
View Item |
