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Patel NC, Torgerson T, Thakar MS, Younger MEM, Sriaroon P, Pozos TC, Buckley RH, Morris D, Vilkama D, Heimall J. Safety and Efficacy of Hizentra® Following Pediatric Hematopoietic Cell Transplant for Treatment of Primary Immunodeficiencies. J Clin Immunol 2023; 43:1557-1565. [PMID: 37266769 PMCID: PMC10499723 DOI: 10.1007/s10875-023-01482-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 04/01/2023] [Indexed: 06/03/2023]
Abstract
Primary immunodeficiency disease (PIDD) comprises a group of disorders of immune function. Some of the most severe PIDD can be treated with hematopoietic cell transplant (HCT). Hizentra® is a 20% liquid IgG product approved for subcutaneous administration in adults and children greater than 2 years of age with PIDD-associated antibody deficiency. Limited information is available on the use of Hizentra® in children following HCT for PIDD. A multicenter retrospective chart review demonstrated 37 infants and children (median age 70.1 [range 12.0 to 176.4] months) with PIDD treated by HCT who received Hizentra® infusions over a median duration of 31 (range 4-96) months post-transplant. The most common indication for HCT was IL2RG SCID (n = 16). Thirty-two patients switched from IVIG to SCIG administration, due to one or more of the following reasons: patient/caregiver (n = 17) or physician (n = 12) preference, discontinuation of central venous catheter (n = 16), desire for home infusion (n = 12), improved IgG serum levels following lower levels on IVIG (n = 10), and loss of venous access (n = 8). Serious bacterial infections occurred at a rate of 0.041 per patient-year while on therapy. Weight percentile increased by a mean of 16% during the observation period, with females demonstrating the largest gains. Mild local reactions were observed in 24%; 76% had no local reactions. One serious adverse event (death from sepsis) was reported. Hizentra® was discontinued in 15 (41%) patients, most commonly due to recovery of B cell function (n = 11). These data demonstrate that Hizentra® is a safe and effective option in children who have received HCT for PIDD.
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Affiliation(s)
- Niraj C Patel
- Department of Pediatrics, Division of Allergy and Immunology, Duke University, Durham, NC, USA.
- Atrium Health, Charlotte, NC, USA.
| | | | - Monica S Thakar
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - M Elizabeth M Younger
- Division of Allergy, Immunology and Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Panida Sriaroon
- Division of Allergy and Immunology, University of South Florida, Tampa, FL, USA
| | - Tamara C Pozos
- Department of Clinical Immunology, Children's Minnesota, Minneapolis, MN, USA
| | - Rebecca H Buckley
- Department of Pediatrics, Division of Allergy and Immunology, Duke University, Durham, NC, USA
| | | | - Diana Vilkama
- Department of Clinical Immunology, Children's Minnesota, Minneapolis, MN, USA
| | - Jennifer Heimall
- Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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