Challenges in the Role of Gammaglobulin Replacement Therapy and Vaccination Strategies For Haematological Malignancy.
Patients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) are prone to present with antibody production deficits associated with recurrent or severe bacterial infections that might benefit from human immunoglobulin (Ig) (IVIg/SCIg) replacement therapy. However, the original IVIg tri...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2016-08-01
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| Series: | Frontiers in Immunology |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fimmu.2016.00317/full |
| _version_ | 1819157513915858944 |
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| author | Silvia Sánchez-Ramón Fatima Dhalla Helen Chapel Helen Chapel |
| author_facet | Silvia Sánchez-Ramón Fatima Dhalla Helen Chapel Helen Chapel |
| author_sort | Silvia Sánchez-Ramón |
| collection | DOAJ |
| description | Patients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) are prone to present with antibody production deficits associated with recurrent or severe bacterial infections that might benefit from human immunoglobulin (Ig) (IVIg/SCIg) replacement therapy. However, the original IVIg trial data was done before modern therapies were available and the current indications do not take into account the shift in the immune situation of current treatment combinations and changes in the spectrum of infections. Besides, patients affected by other B cell malignancies present with similar immunodeficiency and manifestations whilst they are not covered by the current IVIg indications. A potential beneficial strategy could be to vaccinate patients at monoclonal B lymphocytosis (MBL) and monoclonal gammopathy of undetermined significance (MGUS) stages (for CLL and MM, respectively) or at B-cell malignancy diagnosis, when better antibody responses are attained. We have to re-emphasise the need for assessing and monitoring specific antibody responses; these are warranted to select adequately those patients for whom early intervention with prophylactic anti-infective therapy and/or IVIg is preferred. This review provides an overview of the current scenario, with a focus on prevention of infection in patients with hematological malignancies and the role of Ig replacement therapy. |
| first_indexed | 2024-12-22T16:09:58Z |
| format | Article |
| id | doaj.art-c39f3ad49a214e98987ee4142a6a72a7 |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-12-22T16:09:58Z |
| publishDate | 2016-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-c39f3ad49a214e98987ee4142a6a72a72022-12-21T18:20:31ZengFrontiers Media S.A.Frontiers in Immunology1664-32242016-08-01710.3389/fimmu.2016.00317208268Challenges in the Role of Gammaglobulin Replacement Therapy and Vaccination Strategies For Haematological Malignancy.Silvia Sánchez-Ramón0Fatima Dhalla1Helen Chapel2Helen Chapel3Hospital Universitario Clínico San CarlosJohn Radcliffe HospitalJohn Radcliffe HospitalUniversity of OxfordPatients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) are prone to present with antibody production deficits associated with recurrent or severe bacterial infections that might benefit from human immunoglobulin (Ig) (IVIg/SCIg) replacement therapy. However, the original IVIg trial data was done before modern therapies were available and the current indications do not take into account the shift in the immune situation of current treatment combinations and changes in the spectrum of infections. Besides, patients affected by other B cell malignancies present with similar immunodeficiency and manifestations whilst they are not covered by the current IVIg indications. A potential beneficial strategy could be to vaccinate patients at monoclonal B lymphocytosis (MBL) and monoclonal gammopathy of undetermined significance (MGUS) stages (for CLL and MM, respectively) or at B-cell malignancy diagnosis, when better antibody responses are attained. We have to re-emphasise the need for assessing and monitoring specific antibody responses; these are warranted to select adequately those patients for whom early intervention with prophylactic anti-infective therapy and/or IVIg is preferred. This review provides an overview of the current scenario, with a focus on prevention of infection in patients with hematological malignancies and the role of Ig replacement therapy.http://journal.frontiersin.org/Journal/10.3389/fimmu.2016.00317/fullMultiple Myelomahypogammaglobulinemiachronic lymphocytic leukemiaHaematological malignancyantibody production defectreplacement immunoglobulins. |
| spellingShingle | Silvia Sánchez-Ramón Fatima Dhalla Helen Chapel Helen Chapel Challenges in the Role of Gammaglobulin Replacement Therapy and Vaccination Strategies For Haematological Malignancy. Frontiers in Immunology Multiple Myeloma hypogammaglobulinemia chronic lymphocytic leukemia Haematological malignancy antibody production defect replacement immunoglobulins. |
| title | Challenges in the Role of Gammaglobulin Replacement Therapy and Vaccination Strategies For Haematological Malignancy. |
| title_full | Challenges in the Role of Gammaglobulin Replacement Therapy and Vaccination Strategies For Haematological Malignancy. |
| title_fullStr | Challenges in the Role of Gammaglobulin Replacement Therapy and Vaccination Strategies For Haematological Malignancy. |
| title_full_unstemmed | Challenges in the Role of Gammaglobulin Replacement Therapy and Vaccination Strategies For Haematological Malignancy. |
| title_short | Challenges in the Role of Gammaglobulin Replacement Therapy and Vaccination Strategies For Haematological Malignancy. |
| title_sort | challenges in the role of gammaglobulin replacement therapy and vaccination strategies for haematological malignancy |
| topic | Multiple Myeloma hypogammaglobulinemia chronic lymphocytic leukemia Haematological malignancy antibody production defect replacement immunoglobulins. |
| url | http://journal.frontiersin.org/Journal/10.3389/fimmu.2016.00317/full |
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