Immunoglobulin repletion during blinatumomab therapy does not reduce the rate of secondary hypogammaglobulinemia and associated infectious risk.

Autor:	Wo S; Department of Pharmacy, The Mount Sinai Hospital, New York, NY, USA., Levavi H; Division of Hematology/Oncology, Icahn School of Medicine at The Mount Sinai Hospital, New York, NY, USA., Mascarenhas J; Division of Hematology/Oncology, Icahn School of Medicine at The Mount Sinai Hospital, New York, NY, USA., Kremyanskaya M; Division of Hematology/Oncology, Icahn School of Medicine at The Mount Sinai Hospital, New York, NY, USA., Navada S; Division of Hematology/Oncology, Icahn School of Medicine at The Mount Sinai Hospital, New York, NY, USA., Bar-Natan M; Division of Hematology/Oncology, Icahn School of Medicine at The Mount Sinai Hospital, New York, NY, USA., Kim SS; Department of Pharmacy, The Mount Sinai Hospital, New York, NY, USA.
Jazyk:	angličtina
Zdroj:	Blood research [Blood Res] 2022 Jun 30; Vol. 57 (2), pp. 135-143. Date of Electronic Publication: 2022 May 13.
DOI:	10.5045/br.2022.2021163
Abstrakt:	Background: Blinatumomab has demonstrated efficacy in minimal residual disease (MRD) positive and relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL) by inciting rapid and sustained B-cell depletion. Methods: Owing to its effect on B-cells, blinatumomab is associated with a higher rate of secondary hypogammaglobulinemia compared to chemotherapy. To mitigate blinatumomab-induced hypogammaglobulinemia, patients were pre-emptively repleted with intravenous immune globulin (IVIG) during blinatumomab therapy. In this retrospective study, we compared outcomes of 23 blinatumomab treated adults with ALL. Seventeen patients routinely received IVIG and 6 patients were in the control cohort. Results: Our findings demonstrated no difference between the two cohorts in immunoglobulin G (IgG) nadir (338 mg/dL vs. 337 mg/dL, P =0.641), days to IgG nadir (120.5 vs. 85.5 days, P =0.13), infection rate (82.4% vs. 66.7%, P =0.58), infections requiring ICU admission (23.5% vs. 16.7%, P =1), and infection related mortality (17.6% vs. 16.7%, P =1). Conclusion: Pre-emptive IVIG repletion during blinatumomab did not prevent hypogammaglobulinemia and associated infection risk.
Databáze:	MEDLINE
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