Minerva Pediatrica 2019 Jun 28

DOI: 10.23736/S0026-4946.19.05494-X

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Clinical use of polyvalent intravenous immunoglobulins during intensive polichemotherapy in children with acute lymphoblastic leukemia. Retrospective single-centre study

Katarzyna JOWIK ¹ ✉, Patrycja MARCINIAK-STĘPAK ², Katarzyna DERWICH ²

¹ Student's Scientific Association at the Department of Pediatric Oncology Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland; ² Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland

BACKROUND: Acute lymphoblastic leukemia (ALL) is seen in almost 30% of cases of cancer among children. Drop in absolute neutrophil count (ANC) and immunosuppression during chemotherapy are causing the significant increase in the risk of other complications, which can lead to prolonged hospitalization, higher costs of therapy and increased mortality.
METHODS: The analysis concerned 78 patients treated for ALL at the Department of Pediatric Oncology, Hematology and Transplantology. The indications for the use of immunoglobulins, the regimen of administration, the dose and adverse reactions were analyzed.
RESULTS: IVIG was used in 66 (85%) of 78 patients. The standard risk group (SR) was represented by 10 (15%) patients, intermediate (IR) - 29 (44%), and high (HR) - 27 (41%). The most common were 1 and 2-day administrations - 60% and 28%, respectively, of transfusions. The spread of the IVIG doses used ranged from 43 mg to 882 mg/kg body weight. In the SR and IR groups, preparations were transfused at the reinduction stage, while in the HR- consolidation. Among the indications for IVIG, the most common was hypogammaglobulinemia-117 (42%), neutropenia-69 (25%) and infection-62 (22%). During the implementation of 279 patterns of immunoglobulin preparations, 8 (3%) post-transfusion reactions were registered.
CONCLUSIONS: The vast majority of ALL patients required immunoglobulin substitution during polychemotherapy. The supply of preparations is safe, however, there are no unambiguous guidelines regarding their dosage.

KEY WORDS: Acute lymphoblastic leukemia; IVIG - Immunoglobulin - Childhood leukemia