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Prophylactic intravenous immunoglobulin during autologous haemopoietic stem cell transplantation for multiple myeloma is not associated with reduced infectious complications

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Abstract

Patients with multiple myeloma undergoing autologous haemopoietic stem cell transplantation (ASCT) are at high risk for infectious complications. Peri-transplant intravenous immunoglobulin (IVIG) has been used with the aim of reducing these risks. Our retrospective, non-randomised study of peri-transplant IVIG use and effect on infectious complications in 266 ASCTs for myeloma from 2000 to 2009 at a major metropolitan referral centre for haematological malignancies found no difference between those receiving peri-transplant IVIG (0.4 g/kg) (n = 130) and those who were not (n = 110) with regard to bloodstream infections, pneumonia, urinary tract or gastrointestinal infections. When analysed according to pre-transplant therapy (conventional chemotherapy versus novel agents), there was no significant difference in infectious complications between those who did or did not receive peri-transplant IVIG. In conclusion, our study did not show a benefit for the use of peri-transplant IVIG (0.4 g/kg) to reduce infectious complications in a large cohort of patients with myeloma undergoing ASCT. In the absence of data supporting efficacy in this context, there appears to be no benefit in the routine use of IVIG for this purpose.

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Acknowledgements

The authors thank Ms. Linley Bielby for her help in data collection, the clinicians responsible for patient management and Professor John Seymour for review of the manuscript.

Disclosures

EW holds a paid position with the Australian Red Cross Blood Service.

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Authors and Affiliations

  1. Division of Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne, Melbourne, Victoria, Australia

    Piers Blombery, H. Miles Prince, Leon J. Worth, Jo Main, Melissa Yang, Erica M. Wood & David A. Westerman

  2. University of Melbourne, Parkville, Melbourne, Victoria, Australia

    H. Miles Prince & David A. Westerman

  3. Department of Pathology, Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett Street, Melbourne, Victoria, Australia, 8006

    David A. Westerman

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  1. Piers Blombery
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  2. H. Miles Prince
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  3. Leon J. Worth
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  4. Jo Main
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  5. Melissa Yang
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  6. Erica M. Wood
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  7. David A. Westerman
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Correspondence to Piers Blombery.

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Blombery, P., Prince, H.M., Worth, L.J. et al. Prophylactic intravenous immunoglobulin during autologous haemopoietic stem cell transplantation for multiple myeloma is not associated with reduced infectious complications. Ann Hematol 90, 1167–1172 (2011). https://doi.org/10.1007/s00277-011-1275-3

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  • DOI: https://doi.org/10.1007/s00277-011-1275-3

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