Intravenöse Immunglobuline in der Infektionsprävention bei Kindern mit hämatologisch-onkologischen Erkrankungen

 

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Zusammenfassung.

Bei Kindern mit malignen Erkrankungen finden sich vor sowie während einer zytotoxischen Therapie verminderte Antikörperspiegel, was die Rationale für eine prophylaktische Gabe von Immunglobulinen darstellt. Während bei Kindern im Rahmen einer konventionellen Chemotherapie bisher kein Nutzen prophylaktischer intravenöser Immunglobulingaben nachgewiesen werden konnte, können Immunglobuline bei Kindern nach Knochenmarktransplantation oder peripherer Stammzelltransplantation wahrscheinlich die Rate infektiöser Komplikationen verringern und so auch die Überlebensrate dieser Patienten verbessern. Die Postexpositionsprophylaxe nach Kontakt zu Varizellen oder Masern kann für Kinder mit Krebserkrankungen empfohlen werden.

Treatment with intensive myelosuppressive therapy results in decreased levels of immunoglobulins. Whereas pediatric cancer patients undergoing chemotherapy do not benefit from the routine administration of intravenous immunoglobulins, prophylactic intravenous immunoglobulins given after bone marrow transplantation or after peripheral stem cell transplantation reduce infectious complications. Still, prospective clinical trials are needed to define specific treatment groups who can benefit from immunoglobulin support. In addition, randomized studies are required to evaluate the proper dosage and duration of therapy. Passive immunization of children potentially incubated with varicella or measles is generally recommended.

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PD Dr. med. Thomas Lehrnbecher

Pädiatrische Hämatologie und Onkologie
Klinik für Kinderheilkunde III
Universität Frankfurt

Theodor-Stern-Kai 7

60590 Frankfurt

Phone: 0 69/63 01-49 18

Fax: 0 69/63 01-67 00

Email: thomas_lehrnbecher@yahoo.com