Document Detail

Applications of intravenous immunoglobulin in haematology.
MedLine Citation:
PMID:  1633507     Owner:  NLM     Status:  MEDLINE    
Intravenous immunoglobulin (IVIgG) has many potential applications in haematology both as antibody replacement therapy and as an immune-modulater in autoimmune disorders. Antibody replacement appears to be of value in the prophylaxis of infection in low-grade B-cell malignancies, in bone marrow transplant recipients and in children with AIDS, although optimal treatment strategies have not been assessed and determining which patients are likely to derive greatest benefit has been problematic. IVIgG appears to be effective in the prevention or amelioration of CMV-related pathology if given frequently and has also dramatically improved the survival of patients with established interstitial pneumonia when used in combination with ganciclovir. Intriguingly, IVIgG appears to moderate the severity of GVHD in adult transplant recipients. IVIgG has short term efficacy in most patients with ITP but, as long term remissions are uncommon, it has become necessary to be more selective in the use of IVIgG in this disorder. The response to IVIgG in other immune-mediated cytopenias is similar with generally transient improvement but also with occasional spectacular cures. The treatment of the acquired haemophilias with IVIgG has yielded in vivo and vitro evidence to support the idiotype-antiidiotype theory of IVIgG immune-modulation and has also demonstrated significant differences in the sensitivity of coagulation factor autoantibodies and alloantibodies to IVIgG therapy. IVIgG has several roles in pregnancy related disorders, including the management of both mother and fetus in ITP during pregnancy, the antenatal and postnatal management of platelet alloimmunisation and also in the management of severe rhesus isoimmunisation. IVIgG is safe and well tolerated. The expense of this therapy should be balanced against the likely gains and the overall costs of alternative approaches.
A A Todd; P L Yap
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Publication Detail:
Type:  Historical Article; Journal Article; Review    
Journal Detail:
Title:  Blood reviews     Volume:  6     ISSN:  0268-960X     ISO Abbreviation:  Blood Rev.     Publication Date:  1992 Jun 
Date Detail:
Created Date:  1992-08-26     Completed Date:  1992-08-26     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8708558     Medline TA:  Blood Rev     Country:  SCOTLAND    
Other Details:
Languages:  eng     Pagination:  105-17     Citation Subset:  IM; Q; X    
Edinburgh and SE Scotland Blood Transfusion Service, UK.
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MeSH Terms
Adjuvants, Immunologic / therapeutic use
Blood Coagulation Factors / antagonists & inhibitors
Bone Marrow Transplantation / immunology
HIV Infections / therapy
Hematologic Diseases / therapy*
History, 19th Century
History, 20th Century
Immunoglobulins, Intravenous / adverse effects,  history,  therapeutic use*
Neoplasms / immunology,  therapy
Purpura, Thrombocytopenic, Idiopathic / therapy
Reg. No./Substance:
0/Adjuvants, Immunologic; 0/Blood Coagulation Factors; 0/Immunoglobulins, Intravenous

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