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High-Dose Immunoglobulin

  • Tatsuo OyakeEmail author
  • Yoji Ishida
Chapter

Abstract

Approximately 70% of the ITP patients responded to high dose of intravenous immunoglobulin. The 2011 ASH guidelines recommend an initial dose of 1 g/kg as a one-time dose. This dosage may be repeated if necessary. The EU recommendations described that adult ITP patients at high risk of bleeding or prior to surgery to correct the platelet count should be indicated for the administration of intravenous immunoglobulin. Adverse events with intravenous immunoglobulin are common, but generally acceptable. High doses of immunoglobulin are thought to be involved in the Fc receptor blockade of macrophages in the reticuloendothelial system. Several other mechanisms were elucidated.

Keywords

Platelet Count Intravenous Immunoglobulin Idiopathic Thrombocytopenic Purpura Idiopathic Thrombocytopenic Purpura Patient Initial Platelet 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Imbach P, Barandun S, d’Apuzzo V, Baumgartner C, Hirt A, Morell A, Rossi E, Schoni M, Vest M, Wagner HP. High dose intravenous gamma globulin for idiopathic thrombocytopenic purpura in childhood. Lancet. 1981;1:1228–31.CrossRefPubMedGoogle Scholar
  2. 2.
    Bussel JB, Kimberly RP, Inman RD, Schulman I, Cunningham-Rundles C, Cheung N, Smithwick EM, O'Malley J, Barandun S, Hilgartner MW. Intravenous gamma globulin treatment of chronic idiopathic thrombocytopenic purpura. Blood. 1983;62:480–6.PubMedGoogle Scholar
  3. 3.
    Warrier I, Lusher JM. Intravenous gamma globulin treatment for chronic idiopathic thrombocytopenic purpura in children. Am J Med. 1984;76:193–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Carroll RR, Noyes WD, Rosse WF, Kitchen CS. Intravenous immunoglobulin administration in the treatment of severe chronic immune thrombocytopenic purpura. Am J Med. 1984;76:181–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Oral A, Nusbacher J, Hill JB, Lewis JH. Intravenous gamma globulin in the treatment of chronic idiopathic thrombocytopenic purpura in adults. Am J Med. 1984;76:187–92.CrossRefPubMedGoogle Scholar
  6. 6.
    Bussel JB, Pham LC. Intravenous treatment with gammaglobulin in adults with immune thrombocytopenic purpura: review of the literature. Vox Sang. 1987;52:206–11.CrossRefPubMedGoogle Scholar
  7. 7.
    Bussel JB, Eldor A, Kelton JG, Varon D, Brenner B, Gillis S, Angiolillo A, Kulkarni R, Abshire TC, Kelleher J, IGIV-C in ITP Study Group. IGIV, a novel intravenous immunoglobulin: evaluation of safety, efficacy, mechanisms of action, and impact on quality of life. Thromb Haemost. 2004;91:771–8.PubMedGoogle Scholar
  8. 8.
    Rosthøj S, Hedlund-Treutiger I, Rajantie J, Zeller B, Jonsson OG, Elinder G, Wesenberg F, Henter JI, NOPHO ITP Working Group. Duration and morbidity of newly diagnosed idiopathic thrombocytopenic purpura in children: a prospective nordic study of an unselected cohort. J Pediatr. 2003;143(3):302–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Kuhne T, Buchanan GR, Zimmerman S, Michaels LA, Kohan R, Berchtold W, Imbach P, Intercontinental Childhood ITP Study Group. A prospective comparative study of 2540 infants and children with newly diagnosed idiopathic thrombocytopenic purpura (ITP) from the Intercontinental Childhood ITP Study Group. J Pediatr. 2003;143(5):605–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Beck CE, Nathan PC, Parkin PC, Blanchette VS, Macarthur C. Corticosteroids versus intravenous immune globulin for the treatment of acute immune thrombocytopenic purpura in children: a systematic review and meta-analysis of randomized controlled trials. J Pediatr. 2005;147(4):521–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Neuner C, et al. The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia. Blood. 2011;117(16):4190–207.CrossRefGoogle Scholar
  12. 12.
    Cohen YC, Djuibegovic B, Shamai-Lubovitz O, Mozes B. The bleeding risk and natural history of idiopathic thrombocytopenic purpura in patients with persistent low platelet counts. Arch Intern Med. 2000;160(11):1630–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Godeau B, Lesage S, Divine M, Wirquin V, Farcet JP, Bierling P. Treatment of adult chronic autoimmune thrombocytopenic purpura with repeated high-dose intravenous immunoglobulin. Blood. 1993;82:1415–21.PubMedGoogle Scholar
  14. 14.
    Kerr J, Quinti I, Eibl M, Chapel H, Spath PJ, Sewell WA, Salama A, van Schaik IN, Kuijpers TW, Peter HH. Is dosing of therapeutic immunoglobulins optimal? A review of a three-decade long debate in Europe. Front Immunol. 2014;5:629.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Sewell WA, Kerr J, Behr-Gross ME, Peter HH, Kreuth IG Working Group. European consensus proposal for immunoglobulin therapies. Eur J Immunol. 2014;44(8):2207–14.CrossRefPubMedGoogle Scholar
  16. 16.
    Godeau B, Caulier MT, Decuypere L, Rose C, Schaeffer A, Bierling P. Intravenous immunoglobulin for adults with autoimmune thrombocytopenic purpura: results of a randomized trial comparing 0.5 and 1 g/kg b.w. Br J Haematol. 1999;107(4):716–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Bussel J. Intravenous immune serum globulin in immune thrombocytopenia: clinical results and biochemical evaluation. Vox Sang. 1985;49(Suppl 1):44–50.CrossRefPubMedGoogle Scholar
  18. 18.
    Kurlander R, Coleman RE, Moore J, Gockerman J, Rosse W, Siegal R. Comparison of the efficacy of a two-day and a five-day schedule for infusing intravenous gamma globulin in the treatment of immune thrombocytopenic purpura in adults. Am J Med. 1987;83(Suppl 4A):17–24.CrossRefPubMedGoogle Scholar
  19. 19.
    Peng J, Ma SH, Liu J, Hou Y, Liu XM, Niu T, Xu RR, Guo CS, Wang XM, Cheng YF, Ni H, Hou M. Association of autoantibody specificity and response to intravenous immunoglobulin G therapy in immune thrombocytopenia: a multicenter cohort study. J Thromb Haemost. 2014;12(4):497–504.CrossRefPubMedGoogle Scholar
  20. 20.
    Papagianni A, Economou M, Tragiannidis A, Karatza E, Samarah F, Gombakis N, Athanassiadou-Piperopoulou F, Vavatsi-Christaki N, Athanassiou-Metaxa M. FcγRIIa and FcγRIIIa polymorphisms in childhood primary immune thrombocytopenia: implications for disease pathogenesis and outcome. Blood Coagul Fibrinolysis. 2013;24(1):35–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Blanchette VS, Luke B, Andrew M, Sommerville-Nielsen S, Bamard D, De Veber B, Gent M. A prospective, randomized trial of high-dose intravenous immune globulin G therapy, oral prednisone therapy, and no therapy in childhood acute immune thrombocytopenic purpura. J Pediatr. 1993;123:989.CrossRefPubMedGoogle Scholar
  22. 22.
    Duhem C, Dicato MA, Ries F. Side-effects of intravenous immune globulins. Clin Exp Immunol. 1994;97(Suppl 1):79.PubMedPubMedCentralGoogle Scholar
  23. 23.
    Bussel JB, Hanna K, IGIV-C in ITP Study Group. Safety and tolerability of a novel chromatography-based intravenous immunoglobulin when administered at a high infusion rate in patients with immune thrombocytopenic purpura. Am J Hematol. 2007;82(3):192–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Schwab I, Nimmerjahn F. Intravenous immunoglobulin therapy: how does IgG modulate the immune system? Nat Rev Immunol. 2013;13(3):176–89.CrossRefPubMedGoogle Scholar
  25. 25.
    Bouhlal H, Martinvalet D, Teillaud JL, Fridman C, Kazatchkine MD, Bayry J, Lacroix-Desmazes S, Kaveri SV. Natural autoantibodies to Fcγ receptors in intravenous immunoglobulins. J Clin Immunol. 2014;34(Suppl 1):S4–11.CrossRefPubMedGoogle Scholar
  26. 26.
    Newland AC. Annotation: the use and mechanisms of action of intravenous immunoglobulin: an update. Br J Haematol. 1989;72:301–5.CrossRefPubMedGoogle Scholar
  27. 27.
    Saleh M, Court W, Huster W, et al. Effect of commercial immunoglobulin G preparation on human monocyte Fc-receptor dependent binding of antibody coated platelets. Br J Haematol. 1988;68:47–51.CrossRefPubMedGoogle Scholar
  28. 28.
    Kimberly RP, Salmon JE, Bussel JB, Crow MK, Hilgartner MW. Modulation of mononuclear phagocyte function by intravenous γ-globulin. J Immunol. 1984;132(2):745–50.PubMedGoogle Scholar
  29. 29.
    Rossi F, Dietrich G, Kazatchkine MD. Anti-idiotypes against autoantibodies in normal immunoglobulins: evidence for network regulation of human autoimmune responses. Immunol Rev. 1989;110:135–49.CrossRefPubMedGoogle Scholar
  30. 30.
    Zhu D, Ravindranath MH, Terasaki PI, Miyazaki T, Pham T, Jucaud V. Suppression of allo-human leucocyte antigen (HLA) antibodies secreted by B memory cells in vitro: intravenous immunoglobulin (IVIG) versus a monoclonal anti-HLA-E IgG that mimics HLA-I reactivities of IVIG. Clin Exp Immunol. 2014;177(2):464–77.Google Scholar
  31. 31.
    Othy S, Hegde P, Topcu S, Sharma M, Maddur MS, Lacroix-Desmazes S, Bayry J, Kaveri SV. Intravenous gammaglobulin inhibits encephalitogenic potential of pathogenic T cells and interferes with their trafficking to the central nervous system, implicating sphingosine-1 phosphate receptor 1-mammalian target of rapamycin axis. J Immunol. 2013;190(9):4535–41.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2017

Authors and Affiliations

  1. 1.Division of Hematology and Oncology, Department of Internal MedicineIwate Medical University School of MedicineMoriokaJapan

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