Poster Display Malignancy and PID

CLINICAL AND PROGNOSTIC RELEVANCE OF HYPOGAMMAGLOBULINEMIA DISCOVERY AT DIFFUSE-LARGE-B-CELL-LYMPHOMA DIAGNOSIS: A MONOCENTRIC RETROSPECTIVE STUDY OF 96 PATIENTS

Lecture Time
11:05 - 11:06
Presenter
  • ALEXANDRE M. Nguyen, France
Room
Poster Area
Date
20.09.2019, Friday
Session Time
10:00 - 17:00
Board Number
68
Presentation Topic
Malignancy and PID

Abstract

Background and Aims

The increased risk of Diffuse-Large-B-cell-Lymphomas (DLBCL) in the course of B-cell primary immunodeficiencies is well established. Little is known about the frequency and the clinical and prognostic relevance of hypogammaglobulinemia discovered at DLBCL diagnosis.

Methods

We retrospectively extracted from the monocentric lymphoma database of Caen-University-Hospital all patients diagnosed with DLBCL between January 2015 and December 2016 who had a serum electrophoresis (SEP) at diagnosis, before receiving any specific treatments. Patient’s presentation and outcome were analyzed according to the presence or not of a hypogammaglobulinemia (total gammaglobulin level (TGL) <5.5 g/L).

Results

Out of 122 patients diagnosed with DLBCL, 96 (74.8%) had a SEP and 12 (12.5%; 8 males; median age 68 [55—82]) showed a hypogammaglobulinemia. When compared to the 84 patients with normal TGL, no difference was seen regarding demographics, DLBCL stages, or CRP levels. The albuminemia/gammaglobulinemia ratio was higher in patients with hypogammaglobulinemia (7 [4.6—12.2] versus 5 [2.3—7.1], p<0.0001). The hypogammaglobulinemia group had a shorter follow-up duration (median 14 [0.3—35] months versus 25 [0.3—51] months; p<0.001) because of more frequent deaths (83% versus 26%, p=0.03), secondary to infections in 10 out of the 12 patients.

Conclusions

Hypogammaglobulinemia at DLBCL diagnosis was observed in 12.5% of our cohort and may be associated with a worse prognosis. The higher albuminemia/gammaglobulinemia ratio suggests that hypogammaglobulinemia was not linked to metabolic or inflammatory causes. Further studies are needed to determine whether these immunodeficiencies are secondary to DLBCL or primary and the best therapeutic strategy.

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