Hypogammaglobulinemia in newly diagnosed chronic lymphocytic leukemia is a predictor of early death

• Published in: Leukemia & lymphoma Vol. 57; no. 7; pp. 1592 - 1599
• Main Authors: Andersen, Michael Asger, Vojdeman, Fie Juhl, Andersen, Mette Klarskov, Brown, Peter de Nully, Geisler, Christian Hartmann, Weis Bjerrum, Ole, Niemann, Carsten Utoft
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 02.07.2016
• Subjects: Adult; Agammaglobulinemia - diagnosis; Agammaglobulinemia - etiology; Aged; Aged, 80 and over; Biomarkers; Cause of Death; Chromosome Aberrations; Chronic lymphocytic leukemia; Female; Follow-Up Studies; Gene Rearrangement, B-Lymphocyte; Humans; hypogammaglobulinemia; infection; Infection - etiology; Leukemia, Lymphocytic, Chronic, B-Cell - complications; Leukemia, Lymphocytic, Chronic, B-Cell - diagnosis; Leukemia, Lymphocytic, Chronic, B-Cell - mortality; Leukemia, Lymphocytic, Chronic, B-Cell - therapy; Male; Middle Aged; Neoplasm Grading; overall survival; Prognosis; prognostic; treatment free survival; prognostic; overall survival; Chronic lymphocytic leukemia; infection; hypogammaglobulinemia; treatment free survival
• ISSN: 1042-8194; 1029-2403
• DOI: 10.3109/10428194.2016.1142082

Hypogammaglobulinemia is the most common immune deficiency in chronic lymphocytic leukemia (CLL). However, the prognostic significance in terms of morbidity and mortality remains controversial. We here evaluate the significance of hypogammaglobulinemia in terms of infections, treatment-free survival (TFS), and overall survival (OS). A total of 159 consecutive, newly diagnosed patients were included for analysis. Twenty-five patients (16%) had a moderate or severe infection within one year of diagnosis, but no associations were found between low immunoglobulin (Ig) levels and infections. In multivariate analysis, we found age (>65), high Binet stage, high β2-microglobulin, and Ig deficiency to be associated with shorter OS. Decreased levels of IgM, deletion of chromosome 17p and unmutated IGHV status had independent negative impact on TFS. Thus, patients with hypogammaglobulinemia did not suffer more from infections early in the disease course, and decreased Ig had independent negative prognostic impact in CLL.