Chronic lymphocytic leukemia (CLL) is the result of an overproduction of B-cells, which are white blood cells that make antibodies. The overproduction of B-cells is caused by mutations that prevent them from effectively fighting infections and result in them taking up extra space in the bone marrow. As a result, there is a reduced production of healthy white blood cells that are essential for fighting off infections.
Normally, if a B-cell comes across a harmful substance, cancer cell, or microorganism (all of them are also known as pathogens), it produces antibodies that activate other immune cells and create an inflammatory response. This will ensure that whatever substance is detected is effectively eliminated. The B-cell will lock onto the pathogen, ensuring it does not replicate and won’t infect other cells.
Additionally, treatments such as venetoclax and BTK inhibitors, although being considered targeted therapies and, therefore, very selective to kill only cancer cells, can still affect the growth of healthy B-cells, debilitating the immune response as a consequence.
Because of the combination of all these factors, it’s common for patients with CLL to be more prone to getting sick from infections, even when they are not undergoing any treatment. Since they have a weakened immune system, it’s important to have supportive measures in place that ensure their good health and prevent any serious complications.
IVIG, or intravenous immunoglobulin, is a supportive measure that some doctors prescribe when a patient’s immunoglobulin levels are low. It can also be referred to as immunoglobulin replacement therapy.
Immunoglobulins, also known as antibodies, are proteins that specifically recognize and bind to particular pathogens, such as bacteria or viruses, and help immune cells identify and eliminate them.
A blood sample is required to find out if a patient has low immunoglobulin levels; that way, doctors can assess if a patient is eligible to receive an immunoglobulin infusion.
Intravenous Immunoglobulin (IVIG) is a blood product prepared from the serum of multiple donors. It is mainly made of immunoglobulin G (IgG), and it provides a source of infection-fighting antibodies for CLL patients and helps them prevent serious infections.
The donor antibodies are administered intravenously (a needle into the vein). The infusion typically takes between 2-4 hours, depending on the prescribed dose. Patients are monitored at the care facility during the infusion. But it’s also possible to receive the infusion at home. You can talk with your doctor about your infusion options.
People with CLL may only need IVIG once a month if they are actively undergoing treatment with venetoclax or a BTK inhibitor. People not actively undergoing treatment, such as those in watch and wait or individuals who have just finished treatment, may not need IVIG or be administered less frequently. Your health professional will help determine the best dosing schedule based on your needs.
Most people with CLL don’t have any side effects from IVIG. Possible side effects may include temporary headache and flu-like symptoms such as fever and chills (can last 24-48 hours after the infusion). To minimize these effects, healthcare providers might pre-medicate patients with antihistamines or acetaminophen. Slowing the rate of infusion can also help reduce side effects.
People with CLL usually receive the IVIG brand Gammagard. Other brands of IVIG include Privigen and Octagam. Differences between them include factors like the source of donors, the purification process, and the concentration. Patients may respond better to one brand over another.
Insurance companies usually cover the cost of IVIG as long as it is medically necessary.
For people covered by Medicare, Medicare will pay 80% of the IVIG cost. The other 20% must be covered by a supplemental plan or by the patient. Under Part B, only the medicine cost is covered. Supplies and infusion pumps are not covered (see below financial resources to help cover any cost gaps).
IVIG can cost between $5,000 and $10,000 per treatment without insurance. However, many financial resources can help reduce or waive costs and get you the medical help you need.
Several of these financial support programs include:
We want you to get the best treatments you can to help support your quality of life. Difficult side effects like increased risk of infection can be prevented with supportive measures like IVIG. Know your options and talk with your doctor about your immunoglobulin levels. If they are low, review the possibility of getting an IVIG prescription to prevent potentially severe infections.
If you are interested in participating in or finding a clinical trial, locating a CLL specialist, or staying informed about updates on CLL, you can create a free HealthTree Cure Hub account!
Sources:
Chronic lymphocytic leukemia (CLL) is the result of an overproduction of B-cells, which are white blood cells that make antibodies. The overproduction of B-cells is caused by mutations that prevent them from effectively fighting infections and result in them taking up extra space in the bone marrow. As a result, there is a reduced production of healthy white blood cells that are essential for fighting off infections.
Normally, if a B-cell comes across a harmful substance, cancer cell, or microorganism (all of them are also known as pathogens), it produces antibodies that activate other immune cells and create an inflammatory response. This will ensure that whatever substance is detected is effectively eliminated. The B-cell will lock onto the pathogen, ensuring it does not replicate and won’t infect other cells.
Additionally, treatments such as venetoclax and BTK inhibitors, although being considered targeted therapies and, therefore, very selective to kill only cancer cells, can still affect the growth of healthy B-cells, debilitating the immune response as a consequence.
Because of the combination of all these factors, it’s common for patients with CLL to be more prone to getting sick from infections, even when they are not undergoing any treatment. Since they have a weakened immune system, it’s important to have supportive measures in place that ensure their good health and prevent any serious complications.
IVIG, or intravenous immunoglobulin, is a supportive measure that some doctors prescribe when a patient’s immunoglobulin levels are low. It can also be referred to as immunoglobulin replacement therapy.
Immunoglobulins, also known as antibodies, are proteins that specifically recognize and bind to particular pathogens, such as bacteria or viruses, and help immune cells identify and eliminate them.
A blood sample is required to find out if a patient has low immunoglobulin levels; that way, doctors can assess if a patient is eligible to receive an immunoglobulin infusion.
Intravenous Immunoglobulin (IVIG) is a blood product prepared from the serum of multiple donors. It is mainly made of immunoglobulin G (IgG), and it provides a source of infection-fighting antibodies for CLL patients and helps them prevent serious infections.
The donor antibodies are administered intravenously (a needle into the vein). The infusion typically takes between 2-4 hours, depending on the prescribed dose. Patients are monitored at the care facility during the infusion. But it’s also possible to receive the infusion at home. You can talk with your doctor about your infusion options.
People with CLL may only need IVIG once a month if they are actively undergoing treatment with venetoclax or a BTK inhibitor. People not actively undergoing treatment, such as those in watch and wait or individuals who have just finished treatment, may not need IVIG or be administered less frequently. Your health professional will help determine the best dosing schedule based on your needs.
Most people with CLL don’t have any side effects from IVIG. Possible side effects may include temporary headache and flu-like symptoms such as fever and chills (can last 24-48 hours after the infusion). To minimize these effects, healthcare providers might pre-medicate patients with antihistamines or acetaminophen. Slowing the rate of infusion can also help reduce side effects.
People with CLL usually receive the IVIG brand Gammagard. Other brands of IVIG include Privigen and Octagam. Differences between them include factors like the source of donors, the purification process, and the concentration. Patients may respond better to one brand over another.
Insurance companies usually cover the cost of IVIG as long as it is medically necessary.
For people covered by Medicare, Medicare will pay 80% of the IVIG cost. The other 20% must be covered by a supplemental plan or by the patient. Under Part B, only the medicine cost is covered. Supplies and infusion pumps are not covered (see below financial resources to help cover any cost gaps).
IVIG can cost between $5,000 and $10,000 per treatment without insurance. However, many financial resources can help reduce or waive costs and get you the medical help you need.
Several of these financial support programs include:
We want you to get the best treatments you can to help support your quality of life. Difficult side effects like increased risk of infection can be prevented with supportive measures like IVIG. Know your options and talk with your doctor about your immunoglobulin levels. If they are low, review the possibility of getting an IVIG prescription to prevent potentially severe infections.
If you are interested in participating in or finding a clinical trial, locating a CLL specialist, or staying informed about updates on CLL, you can create a free HealthTree Cure Hub account!
Sources:
about the author
Jimena Vicencio
Jimena is an International Medical Graduate and a member of the HealthTree Writing team. She has a passion for languages and is currently learning Japanese. In her free time, she loves playing with her cats. Jimena is also pursuing a bachelor's degree in journalism.
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