title: Hypogammaglobulinemia in newly diagnosed chronic lymphocytic leukemia is a predictor of early death.
abstract: 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.
authors: a Department of Hematology , Copenhagen University Hospital, Rigshospitalet , Denmark ;
authors: Michael Asger
authors: MA
authors: Andersen
authors: a Department of Hematology , Copenhagen University Hospital, Rigshospitalet , Denmark ;
authors: Fie Juhl
authors: FJ
authors: Vojdeman
authors: b Department of Clinical Genetics , Copenhagen University Hospital, Rigshospitalet , Denmark.
authors: Mette Klarskov
authors: MK
authors: Andersen
authors: a Department of Hematology , Copenhagen University Hospital, Rigshospitalet , Denmark ;
authors: Peter de Nully
authors: Pde N
authors: Brown
authors: a Department of Hematology , Copenhagen University Hospital, Rigshospitalet , Denmark ;
authors: Christian Hartmann
authors: CH
authors: Geisler
authors: a Department of Hematology , Copenhagen University Hospital, Rigshospitalet , Denmark ;
authors: Ole
authors: O
authors: Weis Bjerrum
authors: a Department of Hematology , Copenhagen University Hospital, Rigshospitalet , Denmark ;
authors: Carsten Utoft
authors: CU
authors: Niemann
mesh_terms: D000328:Adult; D000361:Agammaglobulinemia / Q000175:diagnosis / Q000209:etiology*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002423:Cause of Death; D002869:Chromosome Aberrations; D005260:Female; D005500:Follow-Up Studies; D015322:Gene Rearrangement, B-Lymphocyte; D006801:Humans; D007239:Infections / Q000209:etiology; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis
chemical_list: D015415:Biomarkers
keywords: Chronic lymphocytic leukemia; hypogammaglobulinemia; infection; overall survival; prognostic; treatment free survival