Incidence and prognostic significance of serum immunoglobulins and paraproteins in patients with chronic lymphocytic leukaemia: another valuable piece of the puzzle
Abstrakt
The present study by Corbigni et al. seems to confirm some of the previously published findings, namely association of IgM paraprotein with advanced clinical stages and TP53 abnormalities, as well as significantly shorter TFS in pts with paraprotein or IgG/IgA deficiency (including multivariate analysis). None of these parameters was significant for shorter overall survival in the multivariate analysis; probably due to recent developments of the therapeutic armamentarium, namely novel targeted oral inhibitors such as ibrutinib, idelalisib, and venetoclax, whose introduction has led to marked survival improvement especially in pts with relapsed/refractory CLL.
Finally, it is important to point out that the present study has several limitations: first, incidence and severity of infectious complications was not recorded; furthermore, there is no information on the cause of death (infection versus CLL progression versus other); subclasses of IgG and IgA have not been tested; also data regarding Ig replacement therapy is not available. Despite these constraints, the study by Corbigni et al. adds another valuable piece to the puzzle of the area investigating humoral immune dysfunction in CLL.