Until recently, prophylaxis of infection in CLL focused on replacement of immunoglobulins which became possible with the availability of intravenous preparations (IVIG). Although conventional chemotherapy regimens cause neutropenia, the frequency of severe infections has not been sufficient to consider antimicrobial prophylaxis. The increased risk and expanded spectrum of infections in patients receiving fludarabine has caused some physicians to suggest several prophylactic measures. It must be emphasized that no organized clinical trials of any of these prophylactic measures, other than IVIG, have been attempted.
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