Incidence of infection according to intravenous immunoglobulin use in autologous hematopoietic stem cell transplant recipients with multiple myeloma

• Published in: Transplant infectious disease 2015-10, Vol.17 (5), p.679-687
• Main Authors: Park, S., Jung, C.W., Jang, J.H., Kim, S.J., Kim, W.S., Kim, K.
• Format: Article
• Language: English
• Subjects: Adult; Aged; autologous hematopoietic stem cell transplantation; Bacterial Infections - epidemiology; Bacterial Infections - immunology; Bacterial Infections - prevention & control; Female; Follow-Up Studies; Hematopoietic Stem Cell Transplantation; Humans; Immunocompromised Host; Immunoglobulins, Intravenous - therapeutic use; Immunologic Factors - therapeutic use; Incidence; infection; intravenous immunoglobulin; IVIG; Male; Middle Aged; multiple myeloma; Multiple Myeloma - immunology; Multiple Myeloma - therapy; Proportional Hazards Models; Retrospective Studies; Risk Factors; Transplantation, Autologous; Virus Diseases - epidemiology; Virus Diseases - immunology; Virus Diseases - prevention & control
• ISSN: 1398-2273; 1399-3062
• DOI: 10.1111/tid.12424

Background Although intravenous immunoglobulin (IVIG) is not routinely recommended, many centers still use IVIG during the post‐hematopoietic stem cell transplant (HSCT) period. Method A total of 162 multiple myeloma (MM) patients who underwent autologous (auto‐) HSCT between January 2008 and June 2013 were retrospectively reviewed. Primary objective was determination of the impact of IVIG on post‐transplant infection, and secondary objectives included identification of overall incidence of infection, type of infection, and risk factors for infection after auto‐HSCT in MM patients. Results After auto‐HSCT, 53 of 162 patients (32.7%) experienced 104 infectious events. Upper respiratory infection was most common (n = 31, 29.8%) and pneumonia (n = 27, 26.0%) and herpes zoster (n = 15, 14.4%) came next. Among the identifiable organisms causing respiratory infection, influenza virus (n = 10) and Pneumococcus (n = 9) were predominant. Incidence of infection was not statistically different according to IVIG use (34.8% in IVIG (−) vs. 31.3% in IVIG (+), P = 0.631). Incidence of infection requiring hospitalization and multiple episodes of infection showed no difference between the groups (P = 0.147, P = 0.156). In a Cox proportional hazard model, none of the factors including age, gender, type of disease, stage, tandem (vs. single) transplantation, and IVIG was prognostic for infectious event after auto‐HSCT (P = 0.955, hazard ratio 0.980 with 95% confidence interval 0.481‐1.997 for IVIG). Conclusion In auto‐HSCT recipients with MM, incidence of post‐transplant infection was not different according to prophylactic IVIG use.