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Secondary immunodeficiency in lymphoproliferative malignancies

Artikel i vetenskaplig tidskrift
Författare Vanda Friman
O. Winqvist
Cecilie Blimark
P. Langerbeins
H. Chapel
F. Dhalla
Publicerad i Hematological Oncology
Volym 34
Nummer/häfte 3
Sidor 121-132
ISSN 0278-0232
Publiceringsår 2016
Publicerad vid Institutionen för biomedicin, avdelningen för infektionssjukdomar
Sidor 121-132
Språk en
Länkar dx.doi.org/10.1002/hon.2323
Ämnesord chronic lymphocytic leukemia, infections, multiple myeloma, prophylaxis, replacement immunoglobulin, secondary immunodeficiencies, supportive therapy
Ämneskategorier Cancer och onkologi

Sammanfattning

Secondary immunodeficiencies occur as a consequence of various diseases, including hematological malignancies, and the use of pharmacological therapies, such as immunosuppressive, anti-inflammatory, and biological drugs. Infections are the main cause of morbidity and mortality in multiple myeloma (MM) and chronic lymphocytic leukemia (CLL) patients. Recent advances in treatment have prolonged the duration of remission and the time between relapse phases in MM and CLL patients. However, managing multiple relapses and the use of salvage therapies can lead to cumulative immunosuppression and a higher risk of infections. The pathogenesis of immune deficiency secondary to lymphoproliferative malignancy is multifactorial including disease- and treatment-related factors. Supportive treatment, including early vaccination, anti-infective prophylaxis, and replacement immunoglobulin, plays a key role in preventing infections in MM and CLL. This article provides an overview of the basic immunology necessary to understand the pathogenesis of secondary immunodeficiency and the infectious complications in MM and CLL. We also discuss the evidence supporting the role of prophylactic replacement immunoglobulin treatment in patients with antibody failure secondary to MM and CLL and the indications for its use. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

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