TY - JOUR
T1 - Clinical relevance of hypogammaglobulinemia, clinical and biologic variables on the infection risk and outcome of patients with stage A chronic lymphocytic leukemia
AU - Mauro, Francesca R.
AU - Morabito, Fortunato
AU - Vincelli, Iolanda D.
AU - Petrucci, Luigi
AU - Campanelli, Melissa
AU - Salaroli, Adriano
AU - Uccello, Giuseppina
AU - Petrungaro, Annamaria
AU - Ronco, Francesca
AU - Raponi, Sara
AU - Nanni, Mauro
AU - Neri, Antonino
AU - Ferrarini, Manlio
AU - Guarini, Anna R.
AU - Foà, Robin
AU - Gentile, Massimo
PY - 2017/6/1
Y1 - 2017/6/1
N2 - The prognostic effect of hypogammaglobulinemia (HGG), clinical and biologic characteristics on the infection risk and outcome has been retrospectively analyzed in 899 patients with stage A chronic lymphocytic leukemia (CLL). Low levels of IgG were recorded in 19.9% of patients at presentation, low levels of IgM and/or IgA in 10.4% and an additional 20% of patients developed HGG during the course of the disease. Before the start of any treatment, 160 (12.9%) patients experienced at least one grade ≥3 infection requiring a systemic anti-infective treatment and/or hospitalization. While IgG levels at diagnosis were not associated with an increased risk of grade ≥3 infection or with an adverse outcome, a significantly increased rate of grade ≥3 infections was recorded in patients with unmutated IGHV (p = 0.011) and unfavorable FISH aberrations (p = 0.009). Late onset HGG, more frequently recorded in patients with Rai stage I–II (p = 0.001) and unmutated IGHV (p = 0.001), was also associated with a higher rate of severe infections (p = 0.002). These data indicate that, stage A patients with clinical and biologic characteristics of a more aggressive disease develop more frequently late onset HGG, grade ≥3 infections and require a closer clinical monitoring.
AB - The prognostic effect of hypogammaglobulinemia (HGG), clinical and biologic characteristics on the infection risk and outcome has been retrospectively analyzed in 899 patients with stage A chronic lymphocytic leukemia (CLL). Low levels of IgG were recorded in 19.9% of patients at presentation, low levels of IgM and/or IgA in 10.4% and an additional 20% of patients developed HGG during the course of the disease. Before the start of any treatment, 160 (12.9%) patients experienced at least one grade ≥3 infection requiring a systemic anti-infective treatment and/or hospitalization. While IgG levels at diagnosis were not associated with an increased risk of grade ≥3 infection or with an adverse outcome, a significantly increased rate of grade ≥3 infections was recorded in patients with unmutated IGHV (p = 0.011) and unfavorable FISH aberrations (p = 0.009). Late onset HGG, more frequently recorded in patients with Rai stage I–II (p = 0.001) and unmutated IGHV (p = 0.001), was also associated with a higher rate of severe infections (p = 0.002). These data indicate that, stage A patients with clinical and biologic characteristics of a more aggressive disease develop more frequently late onset HGG, grade ≥3 infections and require a closer clinical monitoring.
KW - A stage
KW - Chronic lymphocytic leukemia
KW - Hypogammaglobulinemia
KW - Immunoglobulins
KW - Infections
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U2 - 10.1016/j.leukres.2017.02.011
DO - 10.1016/j.leukres.2017.02.011
M3 - Article
AN - SCOPUS:85014965457
VL - 57
SP - 65
EP - 71
JO - Leukemia Research
JF - Leukemia Research
SN - 0145-2126
ER -