[Prevention of infections in patients with lymphoproliferative syndromes and myeloma by nebulization of an IgA concentrate].

Infection of the upper respiratory tract is a major cause of morbidity and mortality in patients with lymphoproliferative syndromes and multiple myeloma. Nebulizations with IgA tested in a randomized double blind trial to evaluate its efficacy to prevent respiratory infections in patients with lymphoproliferative syndromes and multiple myeloma. Forty nine patients were evaluated (chronic lymphocytic leukaemia, 22; multiple myeloma, 11; lymphoma, 8; HCL, 6; Waldenström and lymphoepiteliod tymoma, 1 patient each) were randomized to receive nebulizations every 12 hours during 3 months of IgA or placebo. Seven infectious episodes (4 respiratory tract infections) in 25 IgA treated patients and 25 episodes (16 respiratory tract infections) in 24 control patients were recorded (p <0.0002). Eighteen patients belonging to the treated group remained free of infections against only 5 from the control group (p < 0.001). No difference related to the grade of infections was observed between groups. The arithmetic media for the first infection observed in each group was 45.6 +/- 22.0 days for the IgA treated and 28.6 +/- 17.5 days for the placebo (p < 0.025). According to this study, IgA nebulization therapy was useful to prevent respiratory tract infections and also delay the onset of infection in patients with lymphoproliferative syndromes and myeloma.