Stephen Jolles1, Mauricette Michallet2, Carlo Agostini3, Michael H Albert4, David Edgar5, Roberto Ria6, Livio Trentin7, Vincent Lévy8. 1. Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK. 2. Leon Berard Centre, Claude Bernard University Lyon 1, Lyon, France. 3. Ca' Foncello Internal Medicine 1st and Centre for Immunologic and Respiratory Rare Diseases, Padua University, Padua, Italy. 4. Dr. von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany. 5. St James's Hospital & Trinity College Dublin, Dublin, Ireland. 6. Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro" Medical School, Bari, Italy. 7. Department of Medicine-DIMED, University of Padua, Padua, Italy. 8. Département de Recherche Clinique, Avicenne Hospital, Sorbonne Paris Nord University, Bobigny, France.
Abstract
OBJECTIVES: Secondary antibody deficiency (SAD), associated with severe, recurrent or persistent infections, is common in patients with haematological malignancies (HM), but unifying guidance on immunoglobulin replacement therapy (IgRT) in these patients is lacking. We aimed to develop consensus statements for the use of IgRT in patients with HM. METHODS: A Delphi exercise was employed to test the level of agreement on statements developed by a Task Force based on available data and their clinical experience. In Round 1, an Expert Panel, comprising specialist EU physicians caring for patients with HM, helped to refine the statements. In Round 2, experts rated their agreement with the statements. In Round 3, experts who had scored their agreement as ≤4 were invited to review their agreement based on the overall feedback. RESULTS: Three definitions and 20 statements were formulated and tested for consensus, covering measurement of IgG levels, initiation and discontinuation of IgRT, dosing, and the use of subcutaneous IgG. Consensus (agreement ≥70% on Likert-type scale) was reached for all three definitions and 18 statements. CONCLUSIONS: Recommendations have been developed with the aim of providing guidance for the use of IgRT to prevent severe, recurrent or persistent infections in patients with HM and SAD.
OBJECTIVES:Secondary antibody deficiency (SAD), associated with severe, recurrent or persistent infections, is common in patients with haematological malignancies (HM), but unifying guidance on immunoglobulin replacement therapy (IgRT) in these patients is lacking. We aimed to develop consensus statements for the use of IgRT in patients with HM. METHODS: A Delphi exercise was employed to test the level of agreement on statements developed by a Task Force based on available data and their clinical experience. In Round 1, an Expert Panel, comprising specialist EU physicians caring for patients with HM, helped to refine the statements. In Round 2, experts rated their agreement with the statements. In Round 3, experts who had scored their agreement as ≤4 were invited to review their agreement based on the overall feedback. RESULTS: Three definitions and 20 statements were formulated and tested for consensus, covering measurement of IgG levels, initiation and discontinuation of IgRT, dosing, and the use of subcutaneous IgG. Consensus (agreement ≥70% on Likert-type scale) was reached for all three definitions and 18 statements. CONCLUSIONS: Recommendations have been developed with the aim of providing guidance for the use of IgRT to prevent severe, recurrent or persistent infections in patients with HM and SAD.
Authors: Paul K Keith; Juthaporn Cowan; Amin Kanani; Harold Kim; Gina Lacuesta; Jason K Lee; Jie Chen; Michelle Park; André Gladiator Journal: Allergy Asthma Clin Immunol Date: 2022-08-07 Impact factor: 3.373