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Titolo:
HIGH-DOSE WEEKLY INTRAVENOUS IMMUNOGLOBULIN TO PREVENT INFECTIONS IN PATIENTS UNDERGOING AUTOLOGOUS BONE-MARROW TRANSPLANTATION OR SEVERE MYELOSUPPRESSIVE THERAPY - A STUDY OF THE AMERICAN-BONE-MARROW-TRANSPLANT-GROUP
Autore:
WOLFF SN; FAY JW; HERZIG RH; GREER JP; DUMMER S; BROWN RA; COLLINS RH; STEVENS DA; HERZIG GP;
Indirizzi:
VANDERBILT UNIV,BONE MARROW TRANSPLANT PROGRAM,913 OXFORD HOUSE NASHVILLE TN 37232 BAYLOR UNIV,MED CTR DALLAS TX 75246 UNIV LOUISVILLE LOUISVILLE KY 40292 WASHINGTON UNIV,SCH MED,DIV HEME ONCOL ST LOUIS MO 63110
Titolo Testata:
Annals of internal medicine
fascicolo: 12, volume: 118, anno: 1993,
pagine: 937 - 942
SICI:
0003-4819(1993)118:12<937:HWIITP>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
RELAPSED HODGKINS-DISEASE; IMMUNE GLOBULIN; IGG ANTIBODY; RECIPIENTS; CYCLOPHOSPHAMIDE; ETOPOSIDE; CHEMOTHERAPY; CARMUSTINE; LEUKEMIA;
Keywords:
IMMUNOGLOBULINS, INTRAVENOUS; TRANSPLANTATION, AUTOLOGOUS; BONE MARROW TRANSPLANTATION; OPPORTUNISTIC INFECTIONS; NEUTROPENIA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
35
Recensione:
Indirizzi per estratti:
Citazione:
S.N. Wolff et al., "HIGH-DOSE WEEKLY INTRAVENOUS IMMUNOGLOBULIN TO PREVENT INFECTIONS IN PATIENTS UNDERGOING AUTOLOGOUS BONE-MARROW TRANSPLANTATION OR SEVERE MYELOSUPPRESSIVE THERAPY - A STUDY OF THE AMERICAN-BONE-MARROW-TRANSPLANT-GROUP", Annals of internal medicine, 118(12), 1993, pp. 937-942

Abstract

Objective: To determine whether intravenous immunoglobulin (IVIG) prevents severe infections during autologous bone marrow transplantation or equivalent high-dose myelosuppressive therapy. Design: Randomized, stratified, nonblinded study. Setting: Three tertiary care university hospitals. Patients: One hundred seventy patients entered the study; 82 received IVIG and 88 were untreated controls. The study groups were similar for parameters capable of influencing the likelihood of infection. Interventions: Intravenous immunoglobulin was given weekly at a dose of 500 mg/kg body weight from the initiation of cytotoxic therapy to the resolution of neutropenia. Measurements: The development of bloodstream or other clinically proven infection, platelet use, and the development of alloimmunity to platelet transfusion. Results: Clinical infection, bacteremia, and fungemia occurred in 43%, 35%, and 6% of the IVIG-treated patients and in 44%, 34%, and 9% of the control patients. Gram-positive bacteremia and gram-negative bacteremia occurred in 28% and 11% of the IVIG group and in 23% and 13% of the control group. Death due to infection occurred in 4.9% of IVIG recipients and in 2.3%of controls. None of these observations was statistically significant(P > 0.2). Survival to hospital discharge was achieved in 86.6% of the IVIG group and in 96.6% of the control group. The survival difference (10%; 95% CI, 1.7% to 18.3%; P = 0.02) was due to a higher incidenceof regimen-related toxic death in the IVIG-treated group. Conclusions: The use of IVIG did not prevent infection. Fewer deaths occurred among controls due to a higher incidence of fatal hepatic veno-occlusive disease in patients receiving IVIG.

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Documento generato il 05/07/20 alle ore 10:14:23