Recommendations for Management of Secondary Antibody Deficiency in Multiple Myeloma

Giralt, Sergío; Jolles, Stephen; Kerre, Tessa; Lazarus, Hillard M.; Mustafa, S. Shahzad; Papanicolaou, Genovefa A.; Ria, Roberto; Vinh, Donald C.; Wingard, John R.

doi:10.1016/j.clml.2023.05.008

Cited by 5 publications

(4 citation statements)

References 98 publications

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“…Notably, the consensus found in this survey aligns closely with the recommendations outlined in existing guidelines, illustrating the significant coherence between clinical practice and established directives [13,14,28,[31][32][33].…”

Section: Discussionsupporting

confidence: 69%

“…An international online survey of 230 physicians from seven countries involved in the diagnosis of SID and the prescription of IgRT in patients with hematological malignancies highlighted the need for harmonized, evidence-based diagnostic and treatment guidelines for SID in these patients [30]. Despite recommendations provided by different guidelines [13,14,31,32] regarding the administration of IVIG or subcutaneous immunoglobulin (SCIg) in patients with SID, there is a lack of information on how these recommendations are implemented in daily clinical practice when managing SID. In addition, the EMA guideline [14] highlights the relevance of functional studies of antibody production for IgRT indication beyond hypogammaglobulinemia [2,15].…”

Section: Discussionmentioning

confidence: 99%

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Current Approach in the Management of Secondary Immunodeficiency in Patients with Hematological Malignancies: Spanish Expert Consensus Recommendations

Boqué,

Sánchez-Ramón,

Córdoba

et al. 2023

JCM

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A Delphi-based survey was designed to assess the opinions of clinical hematologists (n = 17) and clinical immunologists (n = 18) from across Spain on secondary immunodeficiencies (SID) in the management of oncohematological patients. There was 100% agreement on the need to have available guidelines for the management of immunodeficiency in hematological patients; to perform a baseline immunological evaluation in patients with chronic lymphocytic leukemia (CLL), multiple myeloma (MM), lymphoma and hematopoietic stem cell transplantation (HSCT) recipients; and to quantify serum IgG, IgA and IgM levels when SID is suspected. More than 90% agreed on the need for active immunization against seasonal influenza and H1N1, pneumococcus and Haemophilus influenzae. There was a consensus on the monitoring of IgG levels every 3 months (83%) and the need to have available a clinical protocol for the use of IVIG in the management of SID (94%), to monitor trough IgG levels to determine the correct IVIG dose (86%) and to discontinue IVIG after the recovery of IgG levels after 12 months of follow-up (77%). The findings of the present survey may be useful recommendations for hematologists and immunologists to improve the management of SID in daily practice.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Current Approach in the Management of Secondary Immunodeficiency in Patients with Hematological Malignancies: Spanish Expert Consensus Recommendations

Boqué,

Sánchez-Ramón,

Córdoba

et al. 2023

JCM

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“…Treatments for PID and SID include prophylactic antibiotic therapy, immunosuppressants to improve symptom control in cases of non-infectious conditions, and immunoglobulin replacement therapy (IgRT) [ 3 , 9 , 22 ]. Lifelong IgRT is the standard of care for patients with PID associated antibody deficiency, and is known to reduce infections, morbidity, and mortality [ 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

“…Lifelong IgRT is the standard of care for patients with PID associated antibody deficiency, and is known to reduce infections, morbidity, and mortality [ 23 , 24 ]. There is also growing evidence to support the use of IgRT in patients with SID [ 22 , 25 – 28 ], as instances of SID can persists for ~2 years, and in some cases antibody levels never recover, and so require long-term IgRT [ 28 ]. IgRT can be administered either intravenously (IVIg) or subcutaneously (SCIg), with both routes of administration reported as effective and well-tolerated [ 20 , 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

Subcutaneous immunoglobulin replacement therapy in patients with immunodeficiencies – impact of drug packaging and administration method on patient reported outcomes

Mallick,

Solomon,

Bassett

et al. 2024

BMC Immunol

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Background Here, the perspective of patients with primary and secondary immunodeficiency receiving subcutaneous immunoglobulin (SCIg) via introductory smaller size pre-filled syringes (PFS) or vials were compared. Methods An online survey was conducted in Canada by the Association des Patients Immunodéficients du Québec (APIQ) (10/2020–03/2021). Survey questions included: reasons for choosing SCIg packaging and administration methods, training experiences, infusion characteristics, and switching methods. The survey captured structured patient-reported outcomes: treatment satisfaction and its sub-domains, symptom state, general health perception, and physical and mental function. Respondents using PFS were compared with vial users, overall and stratified by their administration method (pump or manual push). Results Of the 132 total respondents, 66 respondents used vials, with 38 using a pump and 28 using manual push. PFS (5 and 10 mL sizes) were being used by 120 respondents, with 38 using a pump and 82 using manual push. PFS users were associated with a 17% lower median (interquartile range) SCIg dose (10 [8, 12] vs. 12 [9, 16] g/week, respectively), a significantly shorter infusion preparation time (15 [10, 20] vs. 15 [10, 30] mins, respectively), and a trend for shorter length of infusion (60 [35, 90] vs. 70 [48, 90] mins, respectively) compared with those on vials. Patient-reported treatment satisfaction scores were overall similar between vial and PFS users (including on the domains of effectiveness and convenience), except for a higher score for vials over PFS on the domain of global satisfaction (p=0.02). Conclusions Consistent with prescribing that reflects a recognition of less wastage, PFS users were associated with a significantly lower SCIg dose compared with vial users. PFS users were also associated with shorter pre-infusion times, reflecting simpler administration mechanics compared with vial users. Higher global satisfaction with treatment among vial users compared with PFS users was consistent with users being limited to smaller PFS size options in Canada during the study period. Patient experience on PFS is expected to improve with the introduction of larger PFS sizes. Overall, treatment satisfaction for SCIg remains consistently high with the introduction of PFS packaging compared with vials.

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Chimeric Antigen Receptor T Cell Therapy for Myeloma: Where Are We Now and What Is Needed to Move Chimeric Antigen Receptor T Cells Forward to Earlier Lines of Therapy? Expert Panel Opinion from the American Society for Transplantation and Cellular Therapy

Anderson,

Dhakal,

Jain

et al. 2024

Transplantation and Cellular Therapy

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Recommendations for Management of Secondary Antibody Deficiency in Multiple Myeloma

Cited by 5 publications

References 98 publications

Current Approach in the Management of Secondary Immunodeficiency in Patients with Hematological Malignancies: Spanish Expert Consensus Recommendations

Current Approach in the Management of Secondary Immunodeficiency in Patients with Hematological Malignancies: Spanish Expert Consensus Recommendations

Subcutaneous immunoglobulin replacement therapy in patients with immunodeficiencies – impact of drug packaging and administration method on patient reported outcomes

Chimeric Antigen Receptor T Cell Therapy for Myeloma: Where Are We Now and What Is Needed to Move Chimeric Antigen Receptor T Cells Forward to Earlier Lines of Therapy? Expert Panel Opinion from the American Society for Transplantation and Cellular Therapy

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