Subcutaneous IgG replacement after pediatric SCT
Article first published online: 29 AUG 2012
© 2012 John Wiley & Sons A/S
Volume 16, Issue 8, pages 866–871, December 2012
How to Cite
Sundin, M., Nordin, K., Jostemyr, Y. and Winiarski, J. (2012), Subcutaneous IgG replacement after pediatric SCT. Pediatric Transplantation, 16: 866–871. doi: 10.1111/j.1399-3046.2012.01783.x
- Issue published online: 7 NOV 2012
- Article first published online: 29 AUG 2012
- Accepted for publication 3 July 2012
- bone marrow transplantation;
Sundin M, Nordin K, Jostemyr Y, Winiarski J. Subcutaneous IgG replacement after pediatric SCT.
Abstract: Hypogammaglobulinemia is common after pediatric SCT and IgG replacement is recommended. Some children will have a prolonged hypogammaglobulinemia but may have poor venous access which impedes further iv IgG replacement. In primary antibody deficiencies, sc IgG replacement, performed by parents at home, has been shown to be efficient and to improve life quality. In this study prolonged hypogammaglobulinemia post-SCT was observed in 58 of 158 (37%) children transplanted 2003–2010. Iv IgG (n = 46) and sc IgG (n = 12) replacement was compared and in 32 of 35 surviving children, it was possible to assess family attitudes to the treatment. There was no significant difference in numbers of patients reaching IgG ≥4 g/L (64–96%) or IgG trough levels between the two groups. However, the levels were less variable in the sc IgG group. Side effects associated with the IgG replacement occurred more frequently in the iv IgG group (67.4% vs. 16.7%, p = 0.003). The frequency of clinical infections was equal in the groups. No family in the sc IgG group desired change of route of administration in contrast to the iv IgG group. To conclude, sc IgG replacement is a convenient and safe alternative to iv IgG replacement which should be offered to children undergoing SCT.