The hypogammaglobinemia and impaired T-cell function associated with chronic lymphocytic leukemia (CLL) predispose patients to potentially serious infections. Patients who demonstrate a pattern of repeated infections, such as pneumonia and septicemia, should be treated monthly with prophylactic parenteral gamma globulin. In the initial study published in 1988, the survival probability of patients with initial levels of gammaglobulin of less than 700 mg/dl was significantly lower (P = 0.03) than in patients with initial levels of 700 mg/dl or more. NCCN recommends IVIG prophylaxis when there are recurrent infections requiring antibiotics or hospitalization and IGG levels are below 500. IVIG is FDA indicated for CLL. For Chronic lymphocytic leukemia teh recommended dose is 0.3-0.6 mg/kg every 3-4 weeks.
Hallek M, Cheson BD, Catovsky D, et al. Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines. Blood. Jun 15 2008;111(12):5446-56. [Medline].
Abbott BL. Chronic lymphocytic leukemia: recent advances in diagnosis and treatment. Oncologist. Jan 2006;11(1):21-30
NCCN.ORG, CLL, p.15
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