Supportive Immunglobulingabe beim metastasierten Melanom unter Polychemoimmuntherapie nach dem „Legha‐Protokoll”

Summary: Background and Objective: Metastatic malignant melanoma as one of the most aggressive tumors has got a new and promising therapy option with the polychemoimmunotherapy according to “Legha's protocol” (5 – 7). Facing the relatively high toxicity of this therapy, especially the high rate of infections of 49 % ( 8 ), we decided to perform a supportive treatment with intravenous IgM‐enriched immunoglobulins in order to avoid infections.
Patients/Methods: From 1998 to 2002 we treated 34 patients with metastatic malignant melanoma with the polychemoimmunotherapy according to “Legha's protocol”. Four days after each course (except the first one) patients intravenously got IgM‐enriched immunoglobulins (5 ml/kg, i. e. 250 mg /kg).
Results: Out of 34 patients three patients suffered from different infections during the polychemoimmunotherapy: One patient developed a labial herpes infection after each course, another one a subcutaneous abscess on her forearm after the third course and the third patient had a gluteal abscess after the first course, that means before getting immunoglobulins. In comparison with the infection rate of 49 % given in the literature our observed infection rate as a side effect of Legha's therapy is very low (8,8 %) when combined with supportive immunoglobulins.
Conclusions: The supportive treatment with IgM‐enriched immunoglobulins during the polychemoimmunotherapy according to “Legha's protocol” can significantly reduce the rate of opportunistic infections in these secundarily immunosuppressed patients.