{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:07:03Z","timestamp":1791245223774,"version":"4.1.0"},"reference-count":39,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Acquired hypogammaglobulinemia is common in chronic lymphocytic leukemia (CLL), non-Hodgkin lymphoma (NHL), and multiple myeloma (MM). No previous systematic reviews (SRs) have compared different approaches to infection prevention. We sought to assess the efficacy and safety of prophylactic immunoglobulin, antibiotics, and vaccination in these patients. We performed an SR and meta-analysis of randomized controlled trials (RCTs) evaluating the efficacy and safety of prophylactic immunoglobulin, antibiotics, and vaccination in adult patients with hematological malignancies commonly associated with acquired hypogammaglobulinemia, specifically, CLL, NHL, and MM. We searched PubMed (MEDLINE), EMBASE, and Cochrane Registry up to 9 January 2021. Results for dichotomous data were expressed as relative risk (RR) with 95% confidence interval (CI) and pooled in a random-effects model. This review was registered with PROSPERO CRD42017070825. From 10\u2009576 studies screened, there were 21 completed RCTs and 1 ongoing. Of these, 8 evaluated prophylactic immunoglobulin (n\u00a0= 370; 7 published before 2000), 5 evaluated prophylactic antibiotics (n\u00a0= 1587), 7 evaluated vaccination (n\u00a0= 3996), and 1 compared immunoglobulin to antibiotics (n\u00a0= 60). Prophylactic immunoglobulin reduced the risk of clinically documented infection (CDI) by 28% (n\u00a0= 2 trials; RR, 0.72; 95% CI, 0.54-0.96), and vaccination reduced the risk by 63% (RR, 0.37; 95% CI, 0.30-0.45). Prophylactic antibiotics did not reduce the risk. No intervention reduced all-cause mortality. Prophylactic immunoglobulin and antibiotics increased the risk of adverse events. Findings should be interpreted with caution, given the high risk of bias in many studies. There is a clear need for high-quality contemporary trials to establish the effectiveness of different approaches to preventing infection.<\/jats:p>","DOI":"10.1182\/bloodadvances.2022008073","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T16:27:28Z","timestamp":1672244848000},"page":"20-31","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":35,"title":["Interventions to reduce infections in patients with hematological malignancies: a systematic review and meta-analysis"],"prefix":"10.1182","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8666-266X","authenticated-orcid":false,"given":"Khai Li","family":"Chai","sequence":"first","affiliation":[{"name":"1Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2974-8023","authenticated-orcid":false,"given":"Jonathan","family":"Wong","sequence":"additional","affiliation":[{"name":"2Department of Hematology, Monash Health, Clayton, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3645-7988","authenticated-orcid":false,"given":"Robert","family":"Weinkove","sequence":"additional","affiliation":[{"name":"3Department of Hematology, Wellington Blood and Cancer Centre at Capital and Coast District Health Board, University of Otago, Wellington, New Zealand"},{"name":"4Cancer Immunotherapy Programme at Malaghan Institute of Medical Research, University of Otago, Wellington, New Zealand"},{"name":"5Department of Pathology and Molecular Medicine, University of Otago, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastazia","family":"Keegan","sequence":"additional","affiliation":[{"name":"6Department of Hematology, King Edward Memorial Hospital, Subiaco, WA, Australia"},{"name":"7Australian Red Cross Lifeblood, Perth, WA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Crispin","sequence":"additional","affiliation":[{"name":"8Department of Hematology, Canberra Hospital, Garran, ACT, Australia"},{"name":"9Medical School, Australian National University, Canberra, ACT, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7414-4950","authenticated-orcid":false,"given":"Simon","family":"Stanworth","sequence":"additional","affiliation":[{"name":"10Department of Hematology, National Health Service Blood and Transplant\/Oxford University Hospitals NHS Trust, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Orla","family":"Morrissey","sequence":"additional","affiliation":[{"name":"11Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7527-2340","authenticated-orcid":false,"given":"Erica M.","family":"Wood","sequence":"additional","affiliation":[{"name":"1Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia"},{"name":"2Department of Hematology, Monash Health, Clayton, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9698-7185","authenticated-orcid":false,"given":"Zoe K.","family":"McQuilten","sequence":"additional","affiliation":[{"name":"1Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia"},{"name":"2Department of Hematology, Monash Health, Clayton, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"issue":"8","key":"2023011817041713200_bib1","doi-asserted-by":"crossref","first-page":"e027473","DOI":"10.1136\/bmjopen-2018-027473","article-title":"The James Lind Alliance process approach: scoping review","volume":"9","author":"Nygaard","year":"2019","journal-title":"BMJ Open"},{"issue":"3","key":"2023011817041713200_bib2","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1111\/imj.14082","article-title":"Managing hypogammaglobulinaemia secondary to haematological malignancies in Australia and New Zealand: a clinician survey","volume":"49","author":"Wong","year":"2019","journal-title":"Intern Med J"},{"key":"2023011817041713200_bib3","first-page":"CD006501","article-title":"Immunoglobulin prophylaxis in hematological malignancies and hematopoietic stem cell transplantation","volume":"4","author":"Raanani","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"2023011817041713200_bib4","first-page":"CD004386","article-title":"Antibiotic prophylaxis for bacterial infections in afebrile neutropenic patients following chemotherapy","volume":"1","author":"Gafter-Gvili","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"issue":"1-2","key":"2023011817041713200_bib5","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1159\/000318900","article-title":"Infections in hematogical cancer patients: the contribution of systematic reviews and meta-analyses","volume":"125","author":"Paul","year":"2011","journal-title":"Acta Haematol"},{"issue":"5","key":"2023011817041713200_bib6","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/ejh.13374","article-title":"Antibiotic prophylaxis for patients with newly diagnosed multiple myeloma: systematic review and meta-analysis","volume":"104","author":"Mohyuddin","year":"2020","journal-title":"Eur J Haematol"},{"issue":"3","key":"2023011817041713200_bib7","first-page":"CD006505","article-title":"Vaccines for prophylaxis of viral infections in patients with hematological malignancies","author":"Cheuk","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"2023011817041713200_bib8","unstructured":"Wyndham\n              A\n            , VoganA, NewtonS, SchubertC. 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