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Opsonising immunoglobulins and mannan-binding lectin in chronic lymphocytic leukemia
J Aittoniemi1, A Miettinen, S Laine
1Department of Clinical Microbiology, Tampere University Hospital, Finland.
Insights
In chronic lymphocytic leukemia (CLL), low immunoglobulin A (IgA) levels independently increase infection risk. Mannan-binding lectin (MBL) concentrations were higher in patients who experienced infections.
Area of Science:
- Immunology
- Hematology
- Infectious Disease
Background:
- Chronic lymphocytic leukemia (CLL) is a hematologic malignancy often associated with immune dysfunction.
- Patients with CLL frequently experience increased susceptibility to infections, impacting morbidity and mortality.
- Understanding the specific immune factors contributing to infection risk is crucial for patient management.
Purpose of the Study:
- To investigate the relationship between plasma immunoglobulin concentrations (IgG, IgA, IgM, IgG subclasses) and mannan-binding lectin (MBL) with infection susceptibility in CLL patients.
- To identify independent risk factors for infection in this patient cohort.
Main Methods:
- Plasma levels of IgG, IgA, IgM, IgG subclasses, and MBL were measured in 28 CLL patients.
- Patients were assessed for increased susceptibility to infection.
- Statistical analyses, including multivariable modeling, were used to determine risk factors.
Main Results:
- Hypogammaglobulinemia was more prevalent in patients with increased infection susceptibility (44% vs 5%).
- Decreased IgG4 and IgG2 levels were associated with higher infection risk.
- Low immunoglobulin A (IgA) concentration emerged as an independent risk factor for infection (P = 0.03).
- Mean MBL concentration was significantly higher in patients with infections compared to those without (6.54 mg/l vs 2.75 mg/l; P = 0.001).
Conclusions:
- Immunoglobulin A deficiency is a significant independent risk factor for infections in CLL patients.
- Elevated MBL levels may be associated with infectious complications in CLL.
- Monitoring IgA and MBL concentrations could aid in managing infectious morbidity in CLL.
Abstract:
We investigated the influence of plasma concentrations of immunoglobulin G (IgG), IgA, IgM, IgG subclasses and mannan-binding lectin (MBL) on susceptibility to infection in patients with chronic lymphocytic leukemia (CLL). Of 28 patients with CLL, increased susceptibility to infection was recorded in nine. Four of them (44%) had hypogammaglobulinemia as opposed to only one (5%) of the 19 patients without increased susceptibility to infection (OR 14.4; 95% CI, 1.6-130). When the effect of IgG subclasses contributing to hypogammaglobulinemia was studied, only the decreased concentrations of IgG4 and IgG2 were associated with increased susceptibility to infection. They, in turn, were intercorrelated and also highly correlated with the concentration of IgA. In fact, when these parameters were studied by a multivariable model, only the decreased concentration of IgA was shown as an independent risk factor for infection (P = 0.03). The mean concentration of MBL was significantly higher in patients with infections than in those without (6.54 mg/l and 2.75 mg/l, respectively; P = 0.001). The monitoring of its concentrations might be useful in the follow-up of infectious morbidity in CLL.