Relationship between hypogammaglobulinemia and survival in diffuse large B cell lymphoma cases

NHL is the most common hematological malignancy and its most common subtype is DLBCL. DLBCL, which makes up approximately 1/3 of the NHLs, is a highly heterogeneous disease. For this reason, determining the prognostic indicators related to the disease constitutes an important step to guide the treatment. In the literature; there are clinical, genetic and immunohistochemical studies in this direction. With the addition of the use of a CD20 monoclonal antibody, rituksimab, to its treatment involving systemic chemotherapy in the 1990s, there was a great improvement in treatment responses. However, with this treatment targeting CD20 + B cells, the development of hypogammaglobulinemia in the post-treatment period and an increased risk of infection associated with this have been proven by many studies. However, there has been no study on the relationship between hypogammaglobulinemia that developed at the time of diagnosis or after treatment and survival. In our study, which included 195 cases with DLBCL, we aimed to determine the survival of patients with hypogammaglobulinemia at the time of diagnosis. Patient files were scanned retrospectively. Demographic data, diagnosis dates, laboratory values, IgG values at the time of diagnosis, disease stages, and treatment responses were recorded. The median follow-up time was 32.8 months (min: 0 max: 166). The demographic characteristics of the patients were homogeneously distributed except serum LDH level and B symptom. The cases were divided into two groups according to the IgG levels at the time of diagnosis. Both overall survival and disease-free survival in the hypogammaglobulinemia arm were significantly reduced compared to the group without hypogammaglobulinemia. Significant differences in OS and PFS continued in the analyzes performed to remove the effect of serum LDH level and B symptom not homogeneously distributed among the groups. Treatment responses could not be concluded significantly due to insufficient number of subgroup patients. Consequently, Prospective, randomized, multicenter comparison studies involving clinical, immunohistochemical, cytogenetic and molecular parameters are required for hypogammaglobulinemia to be a prognostic indicator in predicting overall survival and progression-free survival.