Intravenous immunoglobulin treatment in hematological diseases

Abstract

In the last decade large amounts of intravenous immunoglobulin (IVIg) have been used worldwide. Doubts exist as to whether this increased use is paralleled by a comparable growth of reliable data on the therapeutic effectiveness of IVIg. We performed a literature search using MEDLINE from January 1981 to January 1997 and analysed articles on the use of IVIg in hematological disorders and searched for published guidelines. For most hematological disorders, evidence to use IVIg as first line therapy is not very strong. For many disorders no controlled trials have been performed. In published guidelines, IVIg is only recommended, with a few exceptions, when other treatments have failed or are contraindicated. Therefore the increase of consumption of IVIg can not be explained by an increase in established indications in hematology.