title: [Immunoglobulin substitution in patients with indolent non-Hodgkin's lymphoma].
abstract: BACKGROUND
  Infections are major complications in chronic lymphoproliferative disorders, among them indolent non-Hodgkin's lymphoma (iNHL) including chronic lymphocytic leukemia, follicular lymphoma and multiple myeloma.We report on a retrospective cohort analysis of outpatients with indolent non-Hodgkin's lymphoma who were treated in an oncology / hematology group practice and received intravenous polyvalent immunoglobulin G (IVIG) as supportive care. The aim was to describe the treated iNHL population, the course of therapy and the effects of IVIG administrations on the levels of immunoglobulin G (IgG), the incidence of infections and the survival time.
  
  
  METHODS
  57 patients with secondary iNHL antibody deficiencies (n = 46) or IgG subclass deficiencies (n = 11) who received IVIG substitution were included. Patients received median 11 IVIG doses with a mean dose of 28 g over a period of median 9.5 months.
  
  
  RESULTS
  Mean IgG levels increased with IVIG substitution at about twice and then remained within the normal range. The incidence of infections decreased in 46 % of treated patients. Effects on survival could not be observed. Median overall survival was in the group of substituted patients 124 months (range 7-124), the control group had a median survival time of 96 months (range 3-129) (p = 0.537).
  
  
  CONCLUSIONS
  IgG levels should be reviewed during IVIG substitution on a regular basis and dosage and intervals should be adjusted individually.
authors.affiliation: Praxisklinik für Hämatologie und Onkologie Koblenz.
authors.forename: R
authors.initials: R
authors.lastname: Weide
authors.affiliation: Institut für Versorgungsforschung in der Onkologie (InVO), Koblenz.
authors.forename: S
authors.initials: S
authors.lastname: Feiten
authors.affiliation: Institut für Versorgungsforschung in der Onkologie (InVO), Koblenz.
authors.forename: V
authors.initials: V
authors.lastname: Friesenhahn
authors.affiliation: Praxisklinik für Hämatologie und Onkologie Koblenz.
authors.forename: J
authors.initials: J
authors.lastname: Heymanns
authors.affiliation: Institut für Versorgungsforschung in der Onkologie (InVO), Koblenz.
authors.forename: K
authors.initials: K
authors.lastname: Kleboth
authors.affiliation: Praxisklinik für Hämatologie und Onkologie Koblenz.
authors.forename: J
authors.initials: J
authors.lastname: Thomalla
authors.affiliation: Praxisklinik für Hämatologie und Onkologie Koblenz.
authors.forename: C
authors.initials: C
authors.lastname: van Roye
authors.affiliation: Praxisklinik für Hämatologie und Onkologie Koblenz.
authors.forename: H
authors.initials: H
authors.lastname: Köppler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use; D015994:Incidence; D007239:Infections / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors