Abstract
Objective: Diffuse-large-B-cell-lymphoma (DLBCL) can complicate
B-cell-primary-immunodeficiencies (PIDs) course or induce total
gamma-globulin level (TGL) lowering, whose clinical status as an
effective secondary immunodeficiency (SID) remains unspecified. This
study aims to assess the frequency, clinical and prognostic relevance of
the lowest TGLs discovered at DLBCL diagnosis.
Results: In a two year monocentric retrospective cohort, 96
patients diagnosed with DLBCL who had a serum electrophoresis (SEP) were
included. Patients were divided into the lowest (L)- and the highest
(H)-TGLs (TGL ≤5.5 g/L and TGL >5.5 g/L) subgroups and
compared for outcomes, including fatal infectious events. In our cohort,
12 (12.5%; 8 males; median age: 68 [55—82] years) exhibited
L-TGL. There was no differences regarding demographics,
Ann-Arbor-lymphoma-stages, inflammatory parameters or chemotherapy
regimen between both groups. However, overall (10/12, 83.3% versus
22/96, 26.2%; p=0.03) and infection-related death rates (10/12, 83%
versus 6/96, 6.2%; p<0.001) were significantly higher in the
L-TGL group.
Conclusion: We demonstrate for the first time the strong
negative impact of L-TGL on overall and infection-related mortality in
DLBCL. Prospective studies should distinguish DLBCL-related SIDs from
preexisting humoral PIDs, using biomolecular testing and post-treatment
TGLs monitoring to determine the best management strategy for infectious
risk during DLBCL treatment in L-TGL context.