Reduction of infection frequency by intravenous gammaglobulins during intensive induction therapy for small cell carcinoma of the lung

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Abstract
Thirty-two patients with small cell carcinoma of the lung received intensive induction chemoradiotherapy. In a randomized prospective study, we compared the outcome of patients who received 30 g immunoglobulin i.v. divided into three doses per therapy course for infection prophylaxis (Group A) with patients undergoing the same anti-tumor therapy (Group B). All patients were prospectively randomized to one of two groups in order to evaluate the role of intravenous immunoglobulin therapy for infection prophylaxis. Group A received 30 g intravenous immunoglobulin during each course of chemotherapy. Group B was a control group that received identical chemoradiotherapy but did not receive any immunoglobulin therapy. All patients had a severely impaired cellular immune response. IgG serum concentrations were significantly higher in group A. Patients who received intravenous immunoglobulin had significantly fewer infections during the entire treatment period than patients who did not receive prophylactic treatment. 32 Patienten mit einem kleinzelligen Bronchialkarzinom erhielten eine intensive Induktions- (Chemo- und Radio-)Therapie. In einer randomisierten prospektiven Studie zur Wirksamkeit von Immunglobulinen für die Infektionsprophylaxe verglichen wir Patienten, die 30 g Immunglobuline i.v., in drei Dosen, pro Therapiezyklus erhielten (Gruppe A), mit einer Kontrollgruppe von Patienten (Gruppe B), die dieselbe antitumorale Therapie erhielten. Alle Patienten wiesen eine deutliche Beeinträchtigung der zellulären Immunantwort auf. Die IgG-Serumkonzentration in Gruppe A war signifikant höher als in Gruppe B. Bei Patienten, die intravenöse Immunglobulinprophylaxe erhielten, beobachteten wir signifikant weniger Infektionen während der gesamten Induktionstherapie als bei Patienten, die keine Immunglobuline erhielten.