Humoral Immunodeficiency in CLL and Therapy With Subcutaneous Ig
Status:
Completed
Trial end date:
2020-07-03
Target enrollment:
Participant gender:
Summary
Patients with chronic lymphocytic leukemia (CLL) are at increased risk of infections as
compared to age matched controls, with infections being a major cause of morbidity and
mortality. Previous studies have shown that patients with CLL have both hypogammaglobinemia
and impaired humoral immunity as defined by vaccine responses to both polysaccharide and
peptide antigens. Attempts at decreasing infections in CLL have included therapy with
prophylactic antibiotics and intravenous immunoglobulin. In general clinical practice and in
previous studies, patients have started IV immunoglobulin replacement therapy if they have a
history of serious infection or hypogammaglobinemia (defined as Immunoglobulin G below
500-600 g/dL), but vaccine responses have not been evaluated. This study will identify CLL
patients with humoral immunodeficiency by checking both Ig levels and vaccines responses. In
patients with impaired humoral immunity, the investigators will use subcutaneous
immunoglobulin replacement to show this intervention will increase Ig levels, protective
antibody titers, and be well tolerated.