Session Description

While primary antibody deficiencies (PAD) are the result of genetic defects, secondary antibody deficiencies (SAD) are more prevalent and are the consequence of an underlying condition or medication use. Recently, rituximab has provided clinical proof of concept that targeting B-cells results in a significant benefit to patients with a deregulated B-cell function in autoimmune diseases or haematological malignancies. Consequently, the interest in B-cell targeted therapies has increased and biologics with different targets have been developed. However, these therapies potentially cause iatrogenic hypogammaglobulinaemia and are associated with increased risk of infection. Lymphoma and immunodeficiencies are closely linked. Malignancy and especially lymphoma is the second most prevalent cause of death after infection in PID. The wide use of R-CHOP contributes to the high frequency of hypogammaglobulinemia and increased mortality due to infections.Monitoring immunoglobulin levels may allow for earlier identification of risk and patients who may benefit from immunoglobulin replacement therapy (IgRT). The standard of care for PAD and SAD is IgRT administered intravenously or subcutaneously. There are distinct clinical advantages to subcutaneous administration such as stable serum IgG levels, fewer systemic side effects and high tolerability combined with flexibility of home treatment. Recent clinical data and long-term experience with 16.5% SCIg will be discussed during the session.