title: Prophylactic intravenous immunoglobulin during autologous haemopoietic stem cell transplantation for multiple myeloma is not associated with reduced infectious complications.
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.
authors.affiliation: Division of Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne, Melbourne, Victoria, Australia. piers.blombery@petermac.org
authors.forename: Piers
authors.initials: P
authors.lastname: Blombery
authors.forename: H Miles
authors.initials: HM
authors.lastname: Prince
authors.forename: Leon J
authors.initials: LJ
authors.lastname: Worth
authors.forename: Jo
authors.initials: J
authors.lastname: Main
authors.forename: Melissa
authors.initials: M
authors.lastname: Yang
authors.forename: Erica M
authors.initials: EM
authors.lastname: Wood
authors.forename: David A
authors.initials: DA
authors.lastname: Westerman
mesh_terms: D000328:Adult; D000361:Agammaglobulinemia / Q000209:etiology; D000368:Aged; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D057286:Electronic Health Records; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006785:Hospitals, University; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D009894:Opportunistic Infections / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D016019:Survival Analysis; D014182:Transplantation, Autologous
chemical_list: D016756:Immunoglobulins, Intravenous