Fatal outcome in a patient with metastatic prostate cancer and acquired severe hypogammaglobulinemia with complete absence of mature peripheral blood B-cells.
Common variable immunodeficiency (CVID) is the second most common immunodeficiency and may be classified according to the presence or absence of mature B-cells, the latter subgroup being exceedingly rare. We describe a 66-year-old patient who over six months developed profound hypogammaglobulinemia associated with a complete absence of circulating B-lymphocytes and had a fatal outcome. Immunophenotypic analysis of a bone marrow aspirate demonstrated a strongly reduced number of B-cell precursors (CD34+/CD19+) but normal numbers of CD34+/CD45+ hematopoietic progenitor cells. This case is remarkable with respect to its documented rapid evolution. Possible triggers are discussed, a combination of drug toxicities being the most likely.
Department of Hematology and Oncology, University Medical Center of Freiburg, Hugstetter Str. 55, D-79106 Freiburg i. Br., Germany.
Jens
J
Lohr
Stephan
S
Mielke
Michael
M
Lübbert
Dirk
D
Behringer
D000230:Adenocarcinoma / Q000150:complications / Q000276:immunology / Q000556:secondary*; D000361:Agammaglobulinemia / Q000209:etiology / Q000276:immunology / Q000473:pathology* / Q000628:therapy; D000368:Aged; D001402:B-Lymphocytes / Q000473:pathology*; D001854:Bone Marrow Cells / Q000473:pathology; D017074:Common Variable Immunodeficiency / Q000150:complications / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D016130:Immunophenotyping; D008297:Male; D011471:Prostatic Neoplasms / Q000150:complications / Q000276:immunology / Q000473:pathology*
D016756:Immunoglobulins, Intravenous