TREATMENT OF HYPOGAMMAGLOBULINEMIA IN CHRONIC LYMPHOCYTIC-LEUKEMIA BYLOW-DOSE INTRAVENOUS GAMMA-GLOBULIN

Intravenous immunoglobulin replacement therapy reduces the number of b acterial infections in B-cell chronic lymphocytic leukaemia (B-CLL) pa tients. However, due to the complexity of immunodeficiency in B-CLL an d the cost-effectiveness of replacement therapy, it is important to id entify patients who are likely to benefit from the treatment and to in vestigate which dose should based. 15 patients with hypogammaglobulina emia and a history of recurrent infections received a fixed dose of 10 grams of gammaglobulin intravenously every 3 weeks. Serum IgG levels were significantly higher after three doses (p = 0.0002). and stabiliz ed just above lower reference value after 11 doses. The total number o f infection-related events during 168 months before therapy was compar ed to the total number of infection-related events in 169 months durin g therapy. The number of antibiotic prescriptions was reduced from 78 to 54 (N.S.), the number of admissions to hospital due to infections w as reduced from 16 to 5 (p = 0.047) and the number of febrile episodes was reduced from 63 to 31 (p = 0.004). We conclude that a fixed low d ose of gammaglobulin intravenously can restore normal serum IgG levels in hypogammaglobulinaemic B-CLL patients, and leads to a decreased nu mber of febrile episodes and admissions to hospital due infections.