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.
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. - In: LEUKEMIA RESEARCH. - ISSN 0145-2126. - 57(2017), pp. 65-71.
Clinical relevance of hypogammaglobulinemia, clinical and biologic variables on the infection risk and outcome of patients with stage A chronic lymphocytic leukemia
A. Neri;
2017
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.File | Dimensione | Formato | |
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