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

Stephanie Wo; Hannah Levavi; John Mascarenhas; Marina Kremyanskaya; Shyamala Navada; Michal Bar-Natan; Sara S. Kim

doi:10.5045/br.2022.2021163

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저자정보: Stephanie Wo (Department of Pharmacy The Mount Sinai Hospital New York NY USA) Hannah Levavi (Division of Hematology/Oncology Icahn School of Medicine at The Mount Sinai Hospital New York NY US) John Mascarenhas (Division of Hematology/Oncology Icahn School of Medicine at The Mount Sinai Hospital New York NY US) Marina Kremyanskaya (Division of Hematology/Oncology Icahn School of Medicine at The Mount Sinai Hospital New York NY US) Shyamala Navada (Division of Hematology/Oncology Icahn School of Medicine at The Mount Sinai Hospital New York NY US) Michal Bar-Natan (Division of Hematology/Oncology Icahn School of Medicine at The Mount Sinai Hospital New York NY US) Sara S. Kim (Department of Pharmacy The Mount Sinai Hospital New York NY USA)

저널정보: 대한혈액학회 Blood Research Blood Research Vol.57 No.2

발행연도: 2022.6

수록면: 135 - 143 (9page)

DOI: 10.5045/br.2022.2021163

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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.

#Acute lymphoblastic leukemia #Blinatumomab #Hypogammaglobulinemia #ALL #Intravenous immunoglobulin

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Stephanie Wo

소속기관 Department of Pharmacy The Mount Sinai Hospital New York NY USA

주요연구분야 의약학 > 임상의학 > 임상병리학

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Hannah Levavi