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 language | English |
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Pages (from-to) | 65-71 |
Number of pages | 7 |
Journal | Leukemia Research |
Volume | 57 |
DOIs | |
Publication status | Published - 2017 |
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