OBJECTIVES: Patients with congenital, humoral immunodeficiencies are usually treated with intravenous immunoglobulin infusions. Subcutaneous infusions have emerged as an alternative treatment modality also in children. Our institution has run a subcutaneous infusion home therapy program for 6 years, and the purpose of this report is to describe our experience with this regimen. METHODS: The subcutaneous therapy of eight patients with immunodeficiency (three with agammaglobulinemia, one with common variable immunodeficiency, one with severe combined immunodeficiency and bone marrow transplantation, and three with hyper-immunoglobulin M syndrome) was evaluated by chart review and a questionnaire answered by all the families. The infusions were given for at least 3 hours each week by a small syringe driver at home after the family had attended an intensive educational course at the hospital. RESULTS: The children were given a total of approximately 1100 infusions. They started at the age of 2 to 8 (mean, 4.5) years and received these infusions for 1.5 to 6 (mean, 3) years. By administering immunoglobulin doses from 58 to 149 (mean, 97) mg/kg per week, trough serum immunoglobulin G values from 5.2 to 9.6 (mean, 7) g/L were obtained. No serious infections occurred. Short-lasting, local side effects such as swelling and redness were frequently reported, but pain or systemic adverse reactions during or after the infusions were never encountered. CONCLUSIONS: Home therapy with subcutaneous immunoglobulin infusions in children with congenital immunodeficiencies is a feasible and safe treatment alternative.
OBJECTIVES:Patients with congenital, humoral immunodeficiencies are usually treated with intravenous immunoglobulin infusions. Subcutaneous infusions have emerged as an alternative treatment modality also in children. Our institution has run a subcutaneous infusion home therapy program for 6 years, and the purpose of this report is to describe our experience with this regimen. METHODS: The subcutaneous therapy of eight patients with immunodeficiency (three with agammaglobulinemia, one with common variable immunodeficiency, one with severe combined immunodeficiency and bone marrow transplantation, and three with hyper-immunoglobulin M syndrome) was evaluated by chart review and a questionnaire answered by all the families. The infusions were given for at least 3 hours each week by a small syringe driver at home after the family had attended an intensive educational course at the hospital. RESULTS: The children were given a total of approximately 1100 infusions. They started at the age of 2 to 8 (mean, 4.5) years and received these infusions for 1.5 to 6 (mean, 3) years. By administering immunoglobulin doses from 58 to 149 (mean, 97) mg/kg per week, trough serum immunoglobulin G values from 5.2 to 9.6 (mean, 7) g/L were obtained. No serious infections occurred. Short-lasting, local side effects such as swelling and redness were frequently reported, but pain or systemic adverse reactions during or after the infusions were never encountered. CONCLUSIONS: Home therapy with subcutaneous immunoglobulin infusions in children with congenital immunodeficiencies is a feasible and safe treatment alternative.
Authors: Ann Gardulf; Uwe Nicolay; Oscar Asensio; Ewa Bernatowska; Andreas Böck; Beatriz Costa Carvalho; Carl Granert; Stefan Haag; Dolores Hernández; Peter Kiessling; Jan Kus; Jaune Pons; Tim Niehues; Sigune Schmidt; Ilka Schulze; Michael Borte Journal: J Clin Immunol Date: 2006-04-26 Impact factor: 8.317
Authors: R Gustafson; A Gardulf; S Hansen; H Leibl; W Engl; M Lindén; A Müller; L Hammarström Journal: Clin Exp Immunol Date: 2008-03-12 Impact factor: 4.330
Authors: John B Hagan; Mary B Fasano; Sheldon Spector; Richard L Wasserman; Isaac Melamed; Mikhail A Rojavin; Othmar Zenker; Jordan S Orange Journal: J Clin Immunol Date: 2010-05-08 Impact factor: 8.317