Intravenous immunoglobulin (IVIG) for Myeloma

Overview
In myeloma, abnormal versions of white blood cells known as plasma B cells proliferate, crowding out healthy cells and forming tumors. Healthy plasma cells secrete proteins called immunoglobulins – also known as Ig or antibodies – that recognize and destroy specific viruses and other threats. However, myeloma cells secrete ineffective antibodies that do not provide protection. Chemotherapy and other treatments for myeloma can further reduce the number of healthy plasma cells, lowering antibody levels and leaving the immune system weakened and open to infections.

One of the reasons doctors regularly test the blood of people with myeloma is to check levels of antibodies. If antibody levels become too low, doctors sometimes recommend that people with myeloma receive intravenous immunoglobulin (IVIG) to bolster their immune system and help protect them from infection.

IVIG is produced by pooling antibodies from thousands of blood donors. The antibodies are purified and sterilized to prevent the transmission of any infection.

What does it involve?
IVIG is administered via intravenous infusion in a medical setting. IVIG treatment is commonly given once a month while antibody levels are low. Antibody levels may rise with effective myeloma treatment or recovery from chemotherapy. As Ig levels rise, you may need IVIG less frequently.

Intended outcomes
The goal of IVIG is to protect people with weakened immune systems from infection.

Results
A study published in 2015 reviewed the incidence of infections in 162 people who underwent autologous stem cell transplant for multiple myeloma. Some participants received IVIG, while others did not. Researchers found that there was not a significant difference in the number of infections or the seriousness of infections between the IVIG group and the non-IVIG group.

Constraints
During or immediately after IVIG, some people experience headache, fatigue, fever, chills, muscle or joint aches, nausea, vomiting, or allergic reactions.

Other side effects may occur a day or so after receiving IVIG. Later effects can include kidney problems, blood clots, and rashes.

Although antibodies are purified and sterilized before packaging for IVIG, there is always a very small chance that they may contain an infectious agent.

For more details about this treatment, visit:
Patient education: Intravenous immune globulin (IVIG) (Beyond the Basics) – UpToDate
https://www.uptodate.com/contents/intravenous-i...

Supportive Care – Leukemia & Lymphoma Society
http://www.lls.org/disease-information/myeloma/...

Supportive Treatments for Patients With Multiple Myeloma – American Cancer Society
https://www.cancer.org/cancer/multiple-myeloma/...

Preparing for Intravenous Immunoglobulin (IVIG) Infusion – American Academy of Allergy, Asthma & Immunology
https://www.aaaai.org/conditions-and-treatments...

Incidence of infection according to intravenous immunoglobulin use in autologous hematopoietic stem cell transplant recipients with multiple myeloma – Transplant Infectious Disease
https://onlinelibrary.wiley.com/doi/abs/10.1111...