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Comparative Study of Immune Status to Infectious Agents in Elderly Patients with Multiple Myeloma, Waldenstrom's Macroglobulinemia, and Monoclonal Gammopathy of Undetermined Significance.

Artikel i vetenskaplig tidskrift
Författare Johanna Karlsson
Björn Andreasson
Nahid Kondori
Evelina Erman
Kristian Riesbeck
Harriet Hogevik
Christine Wennerås
Publicerad i Clinical and vaccine immunology : CVI
Volym 18
Nummer/häfte 6
Sidor 969-77
ISSN 1556-6811
Publiceringsår 2011
Publicerad vid Institutionen för biomedicin, avdelningen för infektionssjukdomar
Sidor 969-77
Språk en
Länkar dx.doi.org/10.1128/CVI.00021-11
Ämnesord Multiple myeloma, Waldenstrom macroglobulinemia, MGUS, infection, immunity
Ämneskategorier Klinisk bakteriologi, Klinisk virologi, Hematologi

Sammanfattning

Whereas patients with multiple myeloma (MM) have a well-documented susceptibility to infections, this has been less studied in other B-cell disorders, such as Waldenstrom's macroglobulinemia (WM) and monoclonal gammopathy of undetermined significance (MGUS). We investigated the humoral immunity to 24 different pathogens in elderly patients with MM (n = 25), WM (n = 16), and MGUS (n = 18) and in age-matched controls (n = 20). Antibody titers against pneumococci, staphylococcal alpha-toxin, tetanus and diphtheria toxoids, and varicella, mumps, and rubella viruses were most depressed in MM patients, next to lowest in WM and MGUS patients, and highest in the controls. In contrast, levels of antibodies specific for staphylococcal teichoic acid, Moraxella catarrhalis, candida, aspergillus, and measles virus were similarly decreased in MM and MGUS patients. Comparable titers in all study groups were seen against Haemophilus influenzae type b (Hib), borrelia, toxoplasma, and members of the herpesvirus family. Finally, a uniform lack of antibodies was noted against Streptococcus pyogenes, salmonella, yersinia, brucella, francisella, and herpes simplex virus type 2. To conclude, although MM patients displayed the most depressed humoral immunity, significantly decreased antibody levels were also evident in patients with WM and MGUS, particularly against Staphylococcus aureus, pneumococci, and varicella. Conversely, immunity was retained for Hib and certain herpesviruses in all study groups.

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