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Актуальность и методы коррекции вторичной гипогаммаглобулинемии в клинической практике

https://doi.org/10.24287/1726-1708-2019-18-3-145-153

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Аннотация

Современные протоколы терапии многих онкологический, гематологических и некоторых наследственных заболеваний могут приводить к развитию тяжелой вторичной гипогаммаглобулинемии. В частности, причиной ее нередко становятся терапия моноклональными антителами к В-клеткам (ритуксимаб, белимумаб, инотузумаб) и ингибиторами тирозинкиназ (иматиниб, дезатиниб), а также применение целого ряда иммуносупрессивных и химиотерапевтических агентов (глюкокортикостероидов, азатиаприна, циклофосфамида и др.). При хроническом лимфолейкозе и множественной миеломе причиной гипогаммаглобулинемии может быть не только специфическая терапия, но и некоторые особенности самих заболеваний. Трансплантация гемопоэтических стволовых клеток также приводит к развитию тяжелой и длительной гипогаммаглобулинемии. Это ассоциировано как с проводимой интенсивной иммуно-/миелоаблативной терапией, так и с особенностями иммунологической реконституции после проведенного лечения. Современные препараты внутривенных иммуноглобулинов (ВВИГ) обладают широким репертуаром патоген-специфической активности при достаточно высоком профиле безопасности и являются неотъемлемой частью сопроводительной терапии пациентов с вторичной гипогаммаглобулинемией. В работе представлен обзор литературных данных о применении ВВИГ в различных клинических ситуациях,  а также несколько клинических примеров из собственного опыта.

Об авторе

Д. Н. Балашов
ФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава России
Россия

Балашов Дмитрий Николаевич, доктор медицинских наук, заведующий отделением трансплантации гемопоэтических стволовых клеток № 2, врач-гематолог

117997, Москва, ГСП-7, ул. Саморы Машела, 1



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Для цитирования:


Балашов Д.Н. Актуальность и методы коррекции вторичной гипогаммаглобулинемии в клинической практике. Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2019;18(3):145-153. https://doi.org/10.24287/1726-1708-2019-18-3-145-153

For citation:


Balashov D.N. Relevance and management of secondary hypogammaglobulinema in clinical practice. Pediatric Hematology/Oncology and Immunopathology. 2019;18(3):145-153. (In Russ.) https://doi.org/10.24287/1726-1708-2019-18-3-145-153

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ISSN 1726-1708 (Print)
ISSN 2414-9314 (Online)