title: Immunoglobulin prophylaxis against cytomegalovirus infection in patients at high risk of infection following allogeneic hematopoietic cell transplantation.
abstract: Reports on the efficacy of intravenous immunoglobulin (IVIG) prophylaxis against cytomegalovirus (CMV) infection after allogeneic hematopoietic cell transplantation (HCT) have often sparked controversy. In addition, we are not aware of any study that has examined whether prophylaxis with IVIG affects the incidence of CMV infection in high-risk patients--those who are elderly or have received human leukocyte antigen (HLA) mismatched HCT. In the present open-label, phase II study, we addressed this question. We enrolled 106 patients in the study. The cumulative incidences of CMV infection at 100 days after HCT were similar in the intervention and the control groups (68% and 64%, P=.89; 89% and 87%, P=.79, respectively, for patients 55 years or older and those who received HLA-mismatched HCT). In those who received HLA-mismatched HCT, 1-year overall survival after HCT was 46% in the intervention group and 40% in the control group (P=.31); for age≥55 years, the corresponding values were 46% and 40% (P=.27). Our data showed that prophylaxis with regular polyvalent IVIG did not affect the incidence of CMV infections or survival among older patients or those who receive HLA-mismatched HCT.
authors.affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ichihara
authors.forename: H
authors.initials: H
authors.lastname: Nakamae
authors.forename: A
authors.initials: A
authors.lastname: Hirose
authors.forename: T
authors.initials: T
authors.lastname: Nakane
authors.forename: H
authors.initials: H
authors.lastname: Koh
authors.forename: Y
authors.initials: Y
authors.lastname: Hayashi
authors.forename: M
authors.initials: M
authors.lastname: Nishimoto
authors.forename: M
authors.initials: M
authors.lastname: Nakamae
authors.forename: M
authors.initials: M
authors.lastname: Yoshida
authors.forename: M
authors.initials: M
authors.lastname: Bingo
authors.forename: H
authors.initials: H
authors.lastname: Okamura
authors.forename: M
authors.initials: M
authors.lastname: Aimoto
authors.forename: M
authors.initials: M
authors.lastname: Manabe
authors.forename: K
authors.initials: K
authors.lastname: Hagihara
authors.forename: Y
authors.initials: Y
authors.lastname: Terada
authors.forename: Y
authors.initials: Y
authors.lastname: Nakao
authors.forename: M
authors.initials: M
authors.lastname: Hino
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003586:Cytomegalovirus Infections / Q000276:immunology / Q000401:mortality / Q000517:prevention & control* / Q000821:virology; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality; D006648:Histocompatibility; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007155:Immunologic Factors / Q000008:administration & dosage*; D015994:Incidence; D007564:Japan; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006680:HLA Antigens; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors