Low immunoglobulin levels carry different risks in lymphoma patients before and during treatment

Rákkutatás · Diffuse large B-cell lymphoma

The clinical meaning of hypogammaglobulinemia differed sharply depending on whether it was present before treatment began or emerged only after therapy

A retrospective, real‑world cohort study from Turkey followed 181 adults with newly diagnosed diffuse large B‑cell lymphoma (DLBCL) who received first‑line rituximab‑based immunochemotherapy. Nearly 60 % developed hypogammaglobulinemia (serum IgG < 7 g/L). Patients with baseline hypogammaglobulinemia had poorer performance status, higher‑risk disease, lower complete‑response rates (73.3 % vs 88.3 % vs 94.6 % for treatment‑emergent and never‑developed groups), and shorter median progression‑free survival (26.4 months) and overall survival (30.9 months). Multivariable analysis demonstrated baseline hypogammaglobulinemia as an independent predictor of infectious complications but not of progression‑free survival. Treatment‑emergent hypogammaglobulinemia was not independently associated with progression‑free survival after a six‑month landmark analysis. The findings highlight the importance of distinguishing pre‑existing versus therapy‑induced antibody deficiency in DLBCL and suggest that baseline low IgG identifies a high‑risk patient subset that may benefit from closer surveillance or prophylactic interventions.

Baseline low immunoglobulin G identifies patients who are already immunocompromised at diagnosis, predisposing them to poorer response to therapy, higher infection risk, and reduced overall survival, whereas treatment‑emergent hypogammaglobulinemia alone does not independently predict worse lymphoma outcomes.

Bizonyítékszint: Sejtvonalas. Laboratóriumi sejtekben vizsgálták.

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