ABSTRACT

Introduction

Secondary immunodeficiency diseases (SID) caused by hematological malignancies (HMs), stem cell transplant (SCT), and associated therapies are mainly characterized by the presence of hypogammaglobulinemia or antibody production deficits.

Areas covered

The authors summarized the scientific literature on disease burden of SIDs in patients who had HMs or SCT. Systematic searches were conducted to identify English-language articles from 1994-2020, reporting on clinical, humanistic, and economic burdens of SID due to HMs or SCT. Definitions of SID and serum immunoglobulin G thresholds varied across 24 eligible studies. In most (n = 16) studies, patients received immunoglobulin replacement therapy (IGRT). Several studies found IGRT was associated with significant reductions in rates of infection and antimicrobial use. However, 1 study found no statistically significant difference in antibiotic use with IGRT. Only 3 studies reported on quality of life, and no economic studies were identified.

Expert opinion

Overall, the findings show several beneficial effects of IGRT on clinical outcomes and quality of life; however, disparate definitions, infrequent reporting of statistical significance, and scarcity of clinical trial data after the 1990s present areas for further investigation. This paucity indicates an unmet need of current evidence to assess the benefits of IGRT in SID.

中文翻译：

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关于免疫球蛋白替代疗法对与血液系统恶性肿瘤和干细胞移植相关的继发性免疫缺陷疾病负担影响的系统文献综述。

摘要

介绍

由血液系统恶性肿瘤 (HMs)、干细胞移植 (SCT) 和相关疗法引起的继发性免疫缺陷病 (SID) 的主要特征是存在低丙种球蛋白血症或抗体产生缺陷。

覆盖区域

作者总结了有关 HMs 或 SCT 患者 SID 疾病负担的科学文献。进行了系统搜索以识别 1994-2020 年的英语文章，报告由于 HMs 或 SCT 导致的 SID 的临床、人文和经济负担。SID 和血清免疫球蛋白 G 阈值的定义在 24 项符合条件的研究中有所不同。在大多数（n = 16）研究中，患者接受了免疫球蛋白替代疗法（IGRT）。几项研究发现 IGRT 与感染率和抗生素使用率的显着降低有关。然而，一项研究发现 IGRT 在抗生素使用方面没有统计学上的显着差异。只有 3 项研究报告了生活质量，没有确定经济研究。

专家意见

总体而言，研究结果显示了 IGRT 对临床结果和生活质量的多种有益影响；然而，1990 年代之后的不同定义、统计显着性报告很少以及临床试验数据稀缺，这些都是需要进一步调查的领域。这种缺乏表明对评估 IGRT 在 SID 中的益处的当前证据的需求未得到满足。