Clinical relevance of hypogammaglobulinemia, clinical and biologic variables on the infection risk and outcome of patients with stage A chronic lymphocytic leukemia

F.R. Mauro, F. Morabito, I.D. Vincelli, L. Petrucci, M. Campanelli, A. Salaroli, G. Uccello, A. Petrungaro, F. Ronco, S. Raponi, M. Nanni, A. Neri, M. Ferrarini, A.R. Guarini, R. Foà, M. Gentile

Research output: Contribution to journalArticle

Abstract

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. © 2017 Elsevier Ltd
Original languageEnglish
Pages (from-to)65-71
Number of pages7
JournalLeukemia Research
Volume57
DOIs
Publication statusPublished - 2017

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Keywords

  • A stage
  • Chronic lymphocytic leukemia
  • Hypogammaglobulinemia
  • Immunoglobulins
  • Infections
  • immunoglobulin A
  • immunoglobulin G
  • immunoglobulin M
  • nanobody
  • adverse outcome
  • aged
  • Article
  • cancer staging
  • chronic lymphatic leukemia
  • clinical feature
  • controlled study
  • disease association
  • disease severity
  • female
  • follow up
  • human
  • immunoglobulin deficiency
  • infection free survival
  • infection risk
  • major clinical study
  • male
  • outcome assessment
  • overall survival
  • patient monitoring
  • prognosis
  • retrospective study
  • sex difference
  • survival
  • treatment free survival
  • adult
  • agammaglobulinemia
  • blood
  • complication
  • infection
  • middle aged
  • pathology
  • risk
  • treatment outcome
  • very elderly
  • Adult
  • Agammaglobulinemia
  • Aged
  • Aged, 80 and over
  • Humans
  • Immunoglobulin G
  • Infection
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk
  • Single-Domain Antibodies
  • Treatment Outcome

Cite this

Mauro, F. R., Morabito, F., Vincelli, I. D., Petrucci, L., Campanelli, M., Salaroli, A., Uccello, G., Petrungaro, A., Ronco, F., Raponi, S., Nanni, M., Neri, A., Ferrarini, M., Guarini, A. R., Foà, R., & Gentile, M. (2017). Clinical relevance of hypogammaglobulinemia, clinical and biologic variables on the infection risk and outcome of patients with stage A chronic lymphocytic leukemia. Leukemia Research, 57, 65-71. https://doi.org/10.1016/j.leukres.2017.02.011