{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T16:11:26Z","timestamp":1789056686871,"version":"build-2803163510"},"reference-count":110,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:00:00Z","timestamp":1726617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Takeda s.p.a."},{"name":"Ministry of Health\u2014Progetto"},{"name":"Societ\u00e0 Italiana di Medicina Interna\u2014SIMI"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Immunoglobulin (Ig) replacement therapy (IgRT) consists of the administration of low-dose human polyclonal Igs for the treatment of primary and secondary hypogammaglobulinemia that are associated with recurrent infections and immune dysfunction. IgRT restores physiological antibody levels and induces an immunomodulatory effect by strengthening immune effector cells, thus reducing infections. Here, we describe the pharmacology of different Ig formulations with a particular focus on their mechanism of action as low-dose IgRT, including the direct anti-microbial effect and the immunomodulatory function. In addition, we describe the use of therapeutic Igs for the management of multiple myeloma (MM), a hematologic malignancy characterized by severe secondary hypogammaglobulinemia associated with poor patient outcome. In MM settings, IgRT prevents life-threatening and recurrent infections showing promising results regarding patient survival and quality of life. Nevertheless, the clinical benefits of IgRT are still controversial. A deeper understanding of the immune-mediated effects of low-dose IgRT will provide the basis for novel combined therapeutic options and personalized therapy in MM and other conditions characterized by hypogammaglobulinemia.<\/jats:p>","DOI":"10.3390\/cancers16183190","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T09:49:19Z","timestamp":1726652959000},"page":"3190","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Immunoglobulin Replacement Therapy: Insights into Multiple Myeloma Management"],"prefix":"10.3390","volume":"16","author":[{"given":"Ilaria","family":"Saltarella","sequence":"first","affiliation":[{"name":"Section of Pharmacology, Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7306-9621","authenticated-orcid":false,"given":"Concetta","family":"Altamura","sequence":"additional","affiliation":[{"name":"Section of Pharmacology, Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2293-9698","authenticated-orcid":false,"given":"Antonio Giovanni","family":"Solimando","sequence":"additional","affiliation":[{"name":"Section of Internal Medicine and Clinical Oncology, Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"D\u2019Amore","sequence":"additional","affiliation":[{"name":"Section of Internal Medicine and Clinical Oncology, Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1515-0090","authenticated-orcid":false,"given":"Roberto","family":"Ria","sequence":"additional","affiliation":[{"name":"Section of Internal Medicine and Clinical Oncology, Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4567-8216","authenticated-orcid":false,"given":"Angelo","family":"Vacca","sequence":"additional","affiliation":[{"name":"Section of Internal Medicine and Clinical Oncology, Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8816-9369","authenticated-orcid":false,"given":"Jean-Fran\u00e7ois","family":"Desaphy","sequence":"additional","affiliation":[{"name":"Section of Pharmacology, Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Antonia","family":"Frassanito","sequence":"additional","affiliation":[{"name":"Section of Clinical Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"ref_1","unstructured":"Justiz Vaillant, A.A., Jamal, Z., Patel, P., and Ramphul, K. 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