Hypogammaglobulinemia is a decrease in serum immunoglobulin G (lgG) level with potential for an immunodeficiency and associated recurrent and severe infections.1,2
Secondary antibody deficiency has a number of causes.3
Expert scientific consensus has identified common haematological conditions and treatments that may predispose a patient to SID:4
- Chronic lymphocytic leukaemia (CLL)
- Multiple myeloma (MM)
- Non-Hodgkin lymphoma (NHL)
- Rituximab, new generations of anti-CD20 monoclonal antibodies, alemtuzumab or fludarabine
- Novel therapies such as B cell targeted treatments, CAR-T and B cell apoptosis inducers
- Post-transplantation with partial immune recovery
SID affect both innate and adaptive immunity; they can be subtle and the clinical apperance heterogeneous:1
- More frequent/recurrent infections
- Unusual infective complications
- Opportunistic infections
References
- Sánchez-Ramón S, et al. Primary and Secondary Immunodeficiency Diseases in Oncohaematology: Warning Signs, Diagnosis, and Management. Front Immunol. 2019; 10: 586.
- Na IK, et al. Current clinical practice and challenges in the management of secondary immunodeficiency in hematological malignancies. Eur J Haematol. 2019;102(6):447-456.
- Casulo et al. Incidence of Hypogammaglobulinemia in Patients Receiving Rituximab and the Use of Intravenous Immunoglobulin for Recurrent Infections. Clin Lymphoma Myeloma Leuk. 2013; 13(2):106-111.
- Sanchez-Ram6n S, et al. Primary and Secondary Immunodeficiency Diseases in Oncohaematology: Warning Signs, Diagnosis, and Management. Front lmmunol. 2019; 10: 586.