Evidence map›Paper›PMID 39113674›Full record

Trial reportHaematologica2025

Immunoglobulin prophylaxis prevents hospital admissions for fever in pediatric acute lymphoblastic leukemia: results of a multicenter randomized trial.

Kirsten A Thus, Hester A De Groot-Kruseman, Pauline Winkler-Seinstra, Marta Fiocco, Heidi Segers, Cor Van den Bos, Inge M Van der Sluis, Wim J E Tissing, Margreet A Veening, Christian Michel Zwaan and 3 more

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Haematologica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Kirsten A ThusPrincess Máxima Center for Pediatric Oncology, Utrecht.
Hester A De Groot-KrusemanPrincess Máxima Center for Pediatric Oncology, Utrecht.
Pauline Winkler-SeinstraPrincess Máxima Center for Pediatric Oncology, Utrecht.
Marta FioccoMathematical Institute Leiden University, Leiden University, Leiden, The Netherlands; Department of Biomedical Data Science, Section Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht.
Heidi SegersDepartment of Pediatric Hemato-Oncology, University Hospitals Leuven, Leuven, Belgium.
Cor Van den BosDepartment of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Amsterdam, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht.
Inge M Van der SluisDepartment of Pediatric Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht.
Wim J E TissingDepartment of Pediatric Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht.
Margreet A VeeningEmma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht.
Christian Michel ZwaanDepartment of Pediatric Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht.
Cornelis M Van TilburgHopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany; Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany; German Cancer Consortium (DKTK), Heidelberg, Germany; National Center for Tumor diseases (NCT), Heidelberg.
Rob PietersPrincess Máxima Center for Pediatric Oncology, Utrecht.
Marc BieringsPrincess Máxima Center for Pediatric Oncology, Utrecht. m.b.bierings-2@prinsesmaximacentrum.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Infections lead to substantial morbidity during the treatment of acute lymphoblastic leukemia (ALL) in which the adaptive immune system is severely affected, leading to declining serum immunoglobulin levels. We performed a trial to investigate whether intravenous immunoglobulin (IVIG) prophylaxis in pediatric patients with ALL could prevent admissions for fever. This randomized controlled trial was a subtrial of the national Dutch multicenter ALL study. Patients aged 1-19 years with medium-risk ALL were randomized into two groups receiving either IVIG prophylaxis (0.7 g/kg IVIG given every 3 weeks, starting on day 22 after diagnosis) or well-defined standard of care (control group). Between October 2012 and March 2019, 91 (51%) patients were randomly assigned to IVIG prophylaxis and 86 (49%) to the control arm. In the IVIG prophylaxis group there were 206 admissions for fever versus 271 in the control group (P=0.011). IVIG prophylaxis was not associated with bacteremia. However, there were significantly fewer admissions for fever with negative blood cultures in the IVIG prophylaxis group than in the control group (113 vs. 200, P<0.001). The difference in number of admissions for fever was observed specifically during maintenance treatment (100 vs. 166, P<0.001) resulting in fewer courses of antibiotic treatment (78 vs. 137, P<0.001) and fewer cases of chemotherapy adaptation (72 vs. 134, P<0.001). In conclusion, in pediatric patients with medium-risk ALL, IVIG prophylaxis was associated with significantly fewer admissions for fever with negative blood cultures during maintenance treatment, resulting in fewer courses of antibiotic treatment and fewer chemotherapy adaptations.

Indexed as

FeverImmunoglobulins, IntravenousPrecursor Cell Lymphoblastic Leukemia-LymphomaAdolescentChildChild, PreschoolFemaleHospitalizationHumansInfantMaleTreatment OutcomeYoung AdultImmunoglobulins, Intravenous

Identifiers

PMID39113674
PMCPMC11694098

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.