Effects of Various Immunoglobulin Products on Serum (1-3)-β-D-glucan Levels

(1-3)-β-D-glucan (β-D-glucan), a component of fungal cell walls and an important diagnostic biomarker of invasive fungal infections, is affected by various factors, particularly in allogeneic hematopoietic cell transplantation (allo-HCT) recipients. Patients receiving allo-HCT also receive immunoglobulin replacement therapy (IgRT); however, little is known about the effects of different types of immunoglobulin products on serum β-D-glucans. Here, we examined the levels of serum β-D-glucan following IgRT, as well as the correlation between changes in serum β-D-glucan and IgG levels.

Serum β-D-glucan levels in patients who underwent allo-HCT and IgRT at our institution between 2021 and 2024 were analyzed retrospectively. Patients who had their serum β-D-glucan measured within 7 days before and after IgRT were included, and changes in serum β-D-glucan levels were evaluated across product types. Finally, the magnitude of these changes was assessed using effect sizes.

A total of 125 administrations of three types of immunoglobulin product (Privegen [n = 63], Venoglobulin [n = 38], and Venilon-I [n = 24]) were examined. The median dose of immunoglobulin was 538.9 (57.4-700.9) mg/kg. We noted a significant increase in serum β-D-glucan levels after administration of Privigen, with a large effect size (Cohen's dz = 0.92; 95% confidence interval 0.48-1.35, p < 0.01). No meaningful changes were detected with Venoglobulin or Venilon-I. Elevated serum β-D-glucan levels returned to baseline within approximately 3 weeks of Privigen administration. Multivariable analysis indicated that Privigen was an independent factor associated with higher serum β-D-glucan levels.

Different immunoglobulin products have different effects on serum β-D-glucan levels after IgRT.