A Cochrane review [Abstract] 1 included 40 studies with a total of 4 682 subjects. Thirty (4 223 patients) included hematopoietic stem cell transplantation (HSCT) patients and ten (459 patients) included patients lymphoproliferative disorders (LPD). When polyvalent immunoglobulins or hyperimmune cytomegalovirus (CMV)-intravenous immunoglobulins (IVIG) were compared to control for HSCT, there was no difference in all-cause mortality RR 0.97 (95% CI 0.87 to 1.09, 12 trials 1 706 patients). Polyvalent immunoglobulins significantly reduced the risk for interstitial pneumonitis (RR 0.64, 95% CI 0.45 to 0.89, 7 trials, 990 patients) but increased the risk for veno-occlusive disease (RR 2.73, 95% CI 1.11 to 6.71, 4 trials 447 patients) and adverse events (RR 8.12 95% CI 3.15 to 20.97, 5 trials 728 patients). In LPD, no benefit in terms of mortality IVIG could be demonstrated (RR 0.86, 95% CI 0.63 to 1.16, 2 trials 163 patients) but there was a decrease in clinically (RR 0.49, 95% CI 0.39 to 0.61) and microbiologically (RR 0.71, 95% CI 0.53 to 0.95) documented infections (3 trials, 205 participants).
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment).
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