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Hypogammaglobulinemia at Diagnosis is Associated With Inferior Survival and Higher Risk of Infections in Diffuse Large B Cell Lymphoma

Lindberg, Åsa LU ; Johansson, Åsa LU ; Kahn, Fredrik LU ; Jönsson, Göran LU and Jerkeman, Mats LU (2025) In Hematological Oncology 43(1).
Abstract

There are some evidences that hypogammaglobulinemia in newly diagnosed diffuse large B cell lymphoma (DLBCL) is a predictor for inferior outcome, but the risk for infection-related admissions specifically related to hypogammaglobulinemia is not known. The aim was to explore if hypogammaglobulinemia in untreated DLBCL in a Swedish cohort was associated with inferior outcome, and to assess the relationship between low immunoglobulin (Ig) levels and infections. Using data from the Swedish Lymphoma Register, we retrospectively identified patients above18 years diagnosed with DLBCL, receiving anthracycline-based curative therapy during 2000–2015 in Southern Sweden with Ig-levels tested at baseline. Data on Ig levels and infections were... (More)

There are some evidences that hypogammaglobulinemia in newly diagnosed diffuse large B cell lymphoma (DLBCL) is a predictor for inferior outcome, but the risk for infection-related admissions specifically related to hypogammaglobulinemia is not known. The aim was to explore if hypogammaglobulinemia in untreated DLBCL in a Swedish cohort was associated with inferior outcome, and to assess the relationship between low immunoglobulin (Ig) levels and infections. Using data from the Swedish Lymphoma Register, we retrospectively identified patients above18 years diagnosed with DLBCL, receiving anthracycline-based curative therapy during 2000–2015 in Southern Sweden with Ig-levels tested at baseline. Data on Ig levels and infections were collected from medical records. Five hundred eighty-five patients were included, median age was 69 years. Hypogammaglobulinemia was detected at baseline in 24%, the most common Ig deficiency was IgG (18%), followed by IgA (10%) and IgM (8%). Hypogammaglobulinemia was associated with inferior overall survival (HR 1.4, 95% CI 1.0–1.8, p-value 0.018), but not when adjusted for International Prognostic Index (IPI). Low levels of Ig were associated with more infections during lymphoma treatment (p-value 0.013), also when adjusted for IPI (p-value < 0.001). Among patients with IgG deficiency, 47% had ≥ 1 infections versus 35% in patients with normal IgG (HR 1.2, p = 0.025). In conclusion, hypogammaglobulinemia was a frequent finding in patients with newly diagnosed DLBCL, with clinical impact in terms of treatment complications and outcome.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
aggressive B-cell non-Hodgkin lymphoma, diagnostic and prognostic biomarkers, hypogammaglobulinemia, survival
in
Hematological Oncology
volume
43
issue
1
article number
e70014
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:85211109290
  • pmid:39627943
ISSN
0278-0232
DOI
10.1002/hon.70014
language
English
LU publication?
yes
id
23e24b6d-e96b-46f7-9f8e-b69d2c3507c5
date added to LUP
2025-03-04 14:41:56
date last changed
2025-07-09 01:40:35
@article{23e24b6d-e96b-46f7-9f8e-b69d2c3507c5,
  abstract     = {{<p>There are some evidences that hypogammaglobulinemia in newly diagnosed diffuse large B cell lymphoma (DLBCL) is a predictor for inferior outcome, but the risk for infection-related admissions specifically related to hypogammaglobulinemia is not known. The aim was to explore if hypogammaglobulinemia in untreated DLBCL in a Swedish cohort was associated with inferior outcome, and to assess the relationship between low immunoglobulin (Ig) levels and infections. Using data from the Swedish Lymphoma Register, we retrospectively identified patients above18 years diagnosed with DLBCL, receiving anthracycline-based curative therapy during 2000–2015 in Southern Sweden with Ig-levels tested at baseline. Data on Ig levels and infections were collected from medical records. Five hundred eighty-five patients were included, median age was 69 years. Hypogammaglobulinemia was detected at baseline in 24%, the most common Ig deficiency was IgG (18%), followed by IgA (10%) and IgM (8%). Hypogammaglobulinemia was associated with inferior overall survival (HR 1.4, 95% CI 1.0–1.8, p-value 0.018), but not when adjusted for International Prognostic Index (IPI). Low levels of Ig were associated with more infections during lymphoma treatment (p-value 0.013), also when adjusted for IPI (p-value &lt; 0.001). Among patients with IgG deficiency, 47% had ≥ 1 infections versus 35% in patients with normal IgG (HR 1.2, p = 0.025). In conclusion, hypogammaglobulinemia was a frequent finding in patients with newly diagnosed DLBCL, with clinical impact in terms of treatment complications and outcome.</p>}},
  author       = {{Lindberg, Åsa and Johansson, Åsa and Kahn, Fredrik and Jönsson, Göran and Jerkeman, Mats}},
  issn         = {{0278-0232}},
  keywords     = {{aggressive B-cell non-Hodgkin lymphoma; diagnostic and prognostic biomarkers; hypogammaglobulinemia; survival}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Hematological Oncology}},
  title        = {{Hypogammaglobulinemia at Diagnosis is Associated With Inferior Survival and Higher Risk of Infections in Diffuse Large B Cell Lymphoma}},
  url          = {{http://dx.doi.org/10.1002/hon.70014}},
  doi          = {{10.1002/hon.70014}},
  volume       = {{43}},
  year         = {{2025}},
}