Jennifer L. Holter, M.D., assistant professor of hematology/oncology and assistant director of the blood and marrow transplant program at the University of Oklahoma Medical Center, answered these questions regarding compromised immune systems and intravenous gamma-globulin treatment.
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Q:Who are the people most likely in need of this therapy?
A:Patients that genetically cannot make adequate amounts of immunoglobulin, patients with autoimmune diseases such as Kawasaki disease, Guillain-Barre syndrome, and patients with chronic infections that have documented IGG levels of 400 mg/dl. Also post-bone marrow transplant patients, and patients with documented viral infection involving the central nervous system, gastrointestinal system or liver.
The basic idea is that the immunoglobulin either provides antibodies present in the blood that patients lack, or the patient has documented infections for which they need more.
Q:How is the need for IGG determined?
A:Documentation of chronic infections and measurement of IGG levels less than 400, and documentation of autoimmune disorder.
Q:What is the blood product, and why is it so expensive?
A:The blood product is derived from pooling several thousand human collections of plasma.
Because it is a pooled blood product, it must be tested extensively for viruses, such as hepatitis and HIV.
Also, it is expensive because of the time and effort needed to collect the product. I think it should be stressed that there is a nationwide shortage of this product currently.
We are, however, able to meet the demand of patients that (have) diseases that need the treatment.
Q:Is it possible for people to have IGG treatment all of their lives?
A:Yes, as long as need for treatment continues.
— Chris Jones
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