Published on July 9, 2020
Can CLL Patients Get IVIG at Home?
With the COVID-19 pandemic curve flattening in some areas and surging in others, the less time you spend in an infusion clinic, the better. This leaves chronic lymphocytic leukemia (CLL) patients who receive intravenous immunoglobulin (IVIG) infusions with two options: forego the treatment they need and stay home; or, weigh the risks and proceed with their infusions as planned.
There is no easy answer. The choice is a very personal one that patients should discuss with their doctors.
But what if there was a third option to consider? Just like telemedicine is having its time in the spotlight due to the coronavirus, are cancer patients and their oncologists exploring at-home infusion therapy as well?
What is IVIG?
Intravenous immunoglobulin (IVIG) is a blood product prepared from the serum of donors. Some CLL patients who have antibody deficiencies receive regular IVIG infusions to boost their immune systems. CLL is a disease of the B cells and the donated antibodies come from B cells.1 The goal of the infusions is to protect immunocompromised patients from infections.
Dr. Susan Leclair, Chancellor Professor Emerita, Department of Medical Laboratory Science, University of Massachusetts Dartmouth, spoke with Patient Power’s Andrew Schorr about the benefits of IVIG infusions for CLL patients.
“What happens with CLL folks is that they either don’t make functional antibodies, or they don't make enough,” Dr. Leclair said.
“So, this is a procedure that is giving you an infusion of antibodies, to keep your system at a place where it won’t get sick when you're in a subway and someone sneezes, when you're in a restaurant and someone coughs at you… it’s protective for you,” she added.
Not all patients need the infusion, however.
“You can measure the immunoglobulin levels in the body, and if they’re normal, you may not need the extra boost, especially if you’re early CLL and watching and waiting. If patients are getting recurrent infections, that’s another reason they might need transfusion,” said Dr. Justin Taylor, a medical oncologist at Memorial Sloan Kettering Cancer Center.
IVIG at Home
For CLL patients who rely on IVIG infusions to protect their immune systems, the answer is yes, IVIG can be infused at home with the help of a health care provider. According to an April 2020 report from the National Home Infusion Foundation (NHIF), home and specialty infusion is a $19 billion industry serving more than 3.2 million patients annually.2
One benefit of at-home infusions is the reduced exposure of immunocompromised patients to pathogens in hospitals and other health care settings. At-home therapy has also been shown to improve quality of life for patients, offering them more independence which results in better adherence to taking medications. What’s more, at-home infusions may save patients and health care providers considerable costs.3
Medicare Part B may cover the cost of infusion at home and hospital but contact your provider to find out for sure.
If you are a CLL patient who receives IVIG infusions, but you are uncomfortable traveling to your local clinic despite strict safety protocols, at-home infusions might be an option. As with all medical decisions, talk to your doctor to get the care that’s right for you.
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~Lauren Evoy Davis
1Jolles S, Sewell WA, Misbah SA. Clinical uses of intravenous immunoglobulin. Clin Exp Immunol. 2005;142(1):1-11.
2National Home Infusion Foundation (NHIF). Infusion Industry Report. April 2020.
3Luthra, R. An Analysis of Intravenous Immunoglobulin Site of Care: Home versus Outpatient Hospital. Am Journ Pharm Benefits. 2014;6:e41-e49.
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