Secondary Immunodeficiency Frequency in Patients with Chronic Lymphocytic Leukemia: The Relationship with Stage and Treatment

Osman Yokus; Konul Jafarli; Fettah Sametoglu; Hasan Goze; Istemi Serin

doi:10.18502/ijhoscr.v16i1.8437

Osman Yokus Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
Konul Jafarli Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
Fettah Sametoglu Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
Hasan Goze Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
Istemi Serin Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey

DOI: https://doi.org/10.18502/ijhoscr.v16i1.8437

Keywords: Immunodeficiency; Chronic lymphocytic leukemia (CLL); Monoclonal antibody; Immunotherapy; Immunoglobulin G (IgG)

Abstract

Background: Chronic lymphocytic leukemia (CLL) is one of the most common hematological malignancies. In patients with CLL, serum immunoglobulin levels decrease over time due to both the disease itself and the chemo-immunotherapeutic agents used. It was aimed to reveal the relationship between hypogammaglobulinemia and disease stage, and chemo-immunotherapies.

Materials and Methods: Data were obtained by retrospectively examining 74 patients who were followed-up between 2008-2019. The relationship between all parameters (demographic characteristics, RAI stages or therapy subtypes) and serum IgG levels was analyzed.

Results: Thirty-two of 74 patients received a therapy. Twenty-two patients were on combined therapy with rituximab or only rituximab and 10 were treated with chemotherapeutic agents only. The frequency of hypogammaglobulinemia was 5.4% at the diagnosis, this rate was 55% in patients receiving a therapy. Hypogammaglobulinemia was higher in advanced stages. In patients with rituximab, higher levels of IgG decrease were observed.

Conclusion: Serum IgG level was significantly lower in patients with advanced-stage, received chemotherapy, especially rituximab. In addition to basal IgG, immunoglobulin levels should be checked during treatment, and follow-up period. Early replacement intravenous immunoglobulins will be important to reduce severe infection attacks due to secondary immunodeficiency.