title: Subcutaneous Immunoglobulin Therapy for Hypogammaglobulinemia Secondary to Malignancy or Related Drug Therapy.
abstract: Immunoglobulin replacement therapy (IRT) has an important role in minimizing infections and improving the health-related quality of life (HRQoL) in patients with immunodeficiency, who would otherwise experience recurrent infections. These plasma-derived products are available as intravenous immunoglobulin (IVIg) or subcutaneous immunoglobulin (SCIg). The global demand for these products is growing rapidly and has placed pressure on supply. Some malignancies and their treatment (as well as other medical therapies) can lead to secondary hypogammaglobulinemia or secondary immunodeficiency (SID) requiring IRT. Although IVIg use in this cohort has well-established therapeutic benefits, little is known about SCIg use. A literature search in July 2015 found only 7 published articles on SCIg use. These articles found that both IRT modes had equivalent efficacy in regard to reduction of bacterial infections. In addition, SCIg was reported to produce higher serum IgG trough levels compared with IVIg on equivalent dosage with the added benefit of fewer adverse effects. Patient HRQoL reports demonstrate preference for SCIg because of reduced adverse effects and hospital visits. There are no health economic models published on SCIg use in SID, but models on primary immunodeficiency disease and IRT conclude that SCIg provided greater economic benefits than IVIg. The findings of this small number of reports suggest that SCIg therapy for patients with SID is likely to be beneficial for both the patient and health care providers. To substantiate wider use of SCIg in SID, larger and more detailed studies are needed to accurately quantify the effectiveness of SCIg.
authors.affiliation: School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia. Electronic address: tanjawindegger@bigpond.com.
authors.forename: Tanja M
authors.initials: TM
authors.lastname: Windegger
authors.affiliation: School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia; Department of Cancer Care Service, Sunshine Coast, Hospital and Health Service,Queensland, Australia.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Lambooy
authors.affiliation: School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia; Safety, Quality and Innovation Unit, Sunshine Coast, Hospital and Health Service, Queensland, Australia.
authors.forename: Leanne
authors.initials: L
authors.lastname: Hollis
authors.affiliation: Department of Immunology, Sunshine Coast, Hospital and Health Service, Queensland, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Morwood
authors.affiliation: Department of Cancer Care Service, Sunshine Coast, Hospital and Health Service,Queensland, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Weston
authors.affiliation: School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia; Department of Anaesthetics, Sunshine Coast, Hospital and Health Service, Queensland, Australia.
authors.forename: Yoke Lin
authors.initials: YL
authors.lastname: Fung
mesh_terms: D000361:Agammaglobulinemia / Q000139:chemically induced / Q000209:etiology / Q000628:therapy*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D006801:Humans; D007116:Immunization, Passive / Q000379:methods; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007153:Immunologic Deficiency Syndromes / Q000139:chemically induced / Q000209:etiology / Q000628:therapy*; D007279:Injections, Subcutaneous; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy / Q000276:immunology*
chemical_list: D000970:Antineoplastic Agents; D016756:Immunoglobulins, Intravenous
keywords: Efficacy; HRQoL; Health economics; Immunoglobulin replacement therapy; SCIg; Secondary hypogammaglobulinemia