PMID- 21415947
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20110714
LR  - 20211020
IS  - 2035-3006 (Electronic)
IS  - 2035-3006 (Linking)
VI  - 2
IP  - 1
DP  - 2010 Apr 20
TI  - Effect of immunoglobulin therapy on the rate of infections in multiple myeloma 
      patients undergoing autologous stem cell transplantation or treated with 
      immunomodulatory agents.
PG  - e2010005
LID - 10.4084/MJHID.2010.005 [doi]
LID - e2010005
AB  - Multiple myeloma (MM) is associated with a significant risk of infection due to 
      immune dysfunction. Infections are a major cause of morbidity and mortality in MM 
      patients. There are few data available regarding the prevalence of infection in 
      MM patients, especially in conjunction with newer generations of immunomodulatory 
      drugs (thalidomide, bortezomib, lenalidomide) or post autologous stem cell 
      transplantation (ASCT). Intravenous immunoglobulin (IVIG) has been used 
      successfully to reduce infection rates in the stable phase of MM, with limited 
      data in other stages.We retrospectively analyzed 47 patients with MM from March 
      2006 to June 2009 at our institution. All patients received thalidomide and 
      steroid therapy for at least 6 months. Nine patients received bortezomib and 11 
      lenalidomide subsequent to thalidomide, because of disease progression, and 22 
      patients underwent ASCT. The median age was 64 years (range 37-86), with a 
      female-to-male ratio of 18:29. The median residual-serum IgG-level at time of 
      infection was 3.2 g/L, IgA 0.3 g/L and IgM 0.2 g/L. Most patients suffered from 
      recurrent moderate to severe bacterial infections, including the ASCT group. 
      Fifteen patients suffered from different degrees of viral infections.All patients 
      except 3 received IVIG therapy with a significant decline of the rate of 
      infection thereafter (p<001). Our analysis shows that patients with MM treated 
      with the new immunomodulatory drugs in conjunction with steroids are at 
      significant increased risk of infection. Employing IVIG therapy appears to be an 
      effective strategy to prevent infection in this cohort of patients. Further 
      studies to confirm these findings are warranted.
FAU - Khalafallah, Alhossain
AU  - Khalafallah A
AD  - Launceston General Hospital, Launceston, Tasmania.
FAU - Maiwald, Matthias
AU  - Maiwald M
FAU - Cox, Amanda
AU  - Cox A
FAU - Burns, Denise
AU  - Burns D
FAU - Bates, Gerald
AU  - Bates G
FAU - Hannan, Terry
AU  - Hannan T
FAU - Seaton, David
AU  - Seaton D
FAU - Fernandopulle, Bernadene
AU  - Fernandopulle B
FAU - Meagher, Damien
AU  - Meagher D
FAU - Brain, Terry
AU  - Brain T
LA  - eng
PT  - Journal Article
DEP - 20100420
PL  - Italy
TA  - Mediterr J Hematol Infect Dis
JT  - Mediterranean journal of hematology and infectious diseases
JID - 101530512
PMC - PMC3033112
EDAT- 2010/01/01 00:00
MHDA- 2010/01/01 00:01
PMCR- 2010/01/01
CRDT- 2011/03/19 06:00
PHST- 2010/03/21 00:00 [received]
PHST- 2010/04/13 00:00 [accepted]
PHST- 2011/03/19 06:00 [entrez]
PHST- 2010/01/01 00:00 [pubmed]
PHST- 2010/01/01 00:01 [medline]
PHST- 2010/01/01 00:00 [pmc-release]
AID - MJHID-2-1-e2010005 [pii]
AID - 10.4084/MJHID.2010.005 [doi]
PST - epublish
SO  - Mediterr J Hematol Infect Dis. 2010 Apr 20;2(1):e2010005. doi: 
      10.4084/MJHID.2010.005.