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

4 Citations (Scopus)

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

Fingerprint

Agammaglobulinemia
B-Cell Chronic Lymphocytic Leukemia
Infection
Immunoglobulin G
Immunoglobulin A
Immunoglobulin M
Hospitalization
Therapeutics

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

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

In: Leukemia Research, Vol. 57, 2017, p. 65-71.

Research output: Contribution to journalArticle

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. / Clinical relevance of hypogammaglobulinemia, clinical and biologic variables on the infection risk and outcome of patients with stage A chronic lymphocytic leukemia. In: Leukemia Research. 2017 ; Vol. 57. pp. 65-71.
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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. {\circledC} 2017 Elsevier Ltd",
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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, F.R.

AU - Morabito, F.

AU - Vincelli, I.D.

AU - Petrucci, L.

AU - Campanelli, M.

AU - Salaroli, A.

AU - Uccello, G.

AU - Petrungaro, A.

AU - Ronco, F.

AU - Raponi, S.

AU - Nanni, M.

AU - Neri, A.

AU - Ferrarini, M.

AU - Guarini, A.R.

AU - Foà, R.

AU - Gentile, M.

N1 - Export Date: 17 January 2018 CODEN: LERED Correspondence Address: Mauro, F.R.; Hematology, Department of Cellular Biotechnologies and Hematology, Policlinico Umberto I, Sapienza UniversityItaly

PY - 2017

Y1 - 2017

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. © 2017 Elsevier Ltd

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. © 2017 Elsevier Ltd

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KW - Chronic lymphocytic leukemia

KW - Hypogammaglobulinemia

KW - Immunoglobulins

KW - Infections

KW - immunoglobulin A

KW - immunoglobulin G

KW - immunoglobulin M

KW - nanobody

KW - adverse outcome

KW - aged

KW - Article

KW - cancer staging

KW - chronic lymphatic leukemia

KW - clinical feature

KW - controlled study

KW - disease association

KW - disease severity

KW - female

KW - follow up

KW - human

KW - immunoglobulin deficiency

KW - infection free survival

KW - infection risk

KW - major clinical study

KW - male

KW - outcome assessment

KW - overall survival

KW - patient monitoring

KW - prognosis

KW - retrospective study

KW - sex difference

KW - survival

KW - treatment free survival

KW - adult

KW - agammaglobulinemia

KW - blood

KW - complication

KW - infection

KW - middle aged

KW - pathology

KW - risk

KW - treatment outcome

KW - very elderly

KW - Adult

KW - Agammaglobulinemia

KW - Aged

KW - Aged, 80 and over

KW - Humans

KW - Immunoglobulin G

KW - Infection

KW - Leukemia, Lymphocytic, Chronic, B-Cell

KW - Middle Aged

KW - Prognosis

KW - Retrospective Studies

KW - Risk

KW - Single-Domain Antibodies

KW - Treatment Outcome

U2 - 10.1016/j.leukres.2017.02.011

DO - 10.1016/j.leukres.2017.02.011

M3 - Article

VL - 57

SP - 65

EP - 71

JO - Leukemia Research

JF - Leukemia Research

SN - 0145-2126

ER -