Prevention of infection in patients with B cell defects: focus on intravenous immunoglobulin

Data with regard to B lymphocyte defects in patients with nonhematologic malignancies are limited. The incidence of bacterial infections following cytotoxic chemotherapy and major surgery appears to be higher for some patients with malignancies, but the infecting organisms are different than those found in patients with primary antibody deficiency. An exception to this are bacterial infections associated with hematologic malignancies, which usually are due to encapsulated bacteria. Antibody replacement therapy with intravenous immunoglobulin may reduce the frequency of infections in patients with hematologic malignancies or in those who have received chemotherapy or undergone major surgery for other malignancies. Better definition of B lymphocyte defects and additional trials of intravenous immunoglobulin therapy to define its role, particularly in relation to other methods of reducing infections, such as antibiotic prophylaxis, are needed.