Chronic Lymphocytic Leukemia-Induced Humoral Immunosuppression: A Systematic Review

Grywalska, Ewelina; Zaborek-Łyczba, Monika; Łyczba, Jakub; Hrynkiewicz, Rafał; Bębnowska, Dominika; Becht, Rafał; Sosnowska‐Pasiarska, Barbara; Smok-Kalwat, Jolanta; Pasiarski, Marcin; Góźdż, Stanisław; Roliński, Jacek; Niedźwiedzka-Rystwej, Paulina

doi:10.3390/cells9112398

Cited by 12 publications

(8 citation statements)

References 56 publications

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“… 43 , 51 , 55 , 56 , 57 The clinical and molecular heterogeneity of CLL patients is well‐known. 58 Since the production of antibodies against the S protein depends on proper T and B cell interaction, both quantitative and qualitative humoral and cellular defects in immune cells reduce response to vaccines.…”

Section: Patients With Cll As the Population At A High Risk Of Non‐response To Covid‐19 Vaccinementioning

confidence: 99%

Reasons and consequences of COVID‐19 vaccine failure in patients with chronic lymphocytic leukemia

Morawska

2021

European J of Haematology

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People with hematologic malignancies are at a high risk of morbidity and mortality from COVID‐19. The response to vaccination is highly limited in patients with chronic lymphocytic leukemia. Less than half of the patients develop antibody response, suggesting that they remain at risk of SARS‐CoV‐2 infection even after the vaccination. Reasons for inadequate response to COVID‐19 vaccination in chronic lymphocytic leukemia are multifactorial and attributed to disease‐related immune dysregulation and patient‐ and therapy‐related factors. The negative predictors of response to vaccination include hypogammaglobulinemia, advanced age, current active treatment, and past treatment anti‐CD20 monoclonal antibodies. Despite using booster doses and heterologous immunization to improve humoral and cellular immunity, some patients with chronic lymphocytic leukemia will fail to respond. Active treatment at the time of vaccination and a recent history of anti‐CD20 monoclonal antibodies use are the strongest predictors of the non‐response. Current data support informing patients with chronic lymphocytic leukemia and other hematologic malignancies about the risk of infection regardless of vaccination. These individuals and members of their households should continue extreme preventive actions despite relaxed local regulations. Other emerging non‐vaccine preventive strategies include passive and post‐exposure prevention with monoclonal antibodies.

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Section: Patients With Cll As the Population At A High Risk Of Non‐response To Covid‐19 Vaccinementioning

confidence: 99%

Reasons and consequences of COVID‐19 vaccine failure in patients with chronic lymphocytic leukemia

Morawska

2021

European J of Haematology

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“…The role for Ig treatment in the present case cannot be determined definitely. However, several reports indicate that substitution of Ig improves the outcome of severe infections in CLL patients and humoral immune deficiencies despite normal IgG and IgM serum levels have been described [8,9,14,15].…”

Section: Discussionmentioning

confidence: 99%

An Eschar-like souvenir from a journey to Colombia: Ecthyma gangrenosum as a differential diagnosis of tropical diseases in immunocompromised patients – a case report

et al. 2021

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Background Ecthyma gangrenosum (EG) is a cutaneous infectious disease characterized by eschar-like skin ulcers typically caused by Pseudomonas aeruginosa. Here, we report a case of relapsing EG in a patient who had returned from a trip to Colombia, thus establishing EG as an important differential diagnosis of tropical diseases, and demonstrating that even long-term antibiotic treatment can result in only partial remission of EG. Case presentation A 77-year-old man with underlying chronic lymphocytic leukemia (CLL) on ibrutinib treatment was admitted because of a superinfected mosquito bite on the left ear and multiple partially necrotic skin lesions disseminated all over the entire body five days after returning from a trip to Colombia. The initial clinical suspicion of a tropical disease (leishmaniosis, systemic mycosis, or others) could not be confirmed. During the diagnostic workup, microbiological cultures of the skin biopsies and bronchoalveolar lavage revealed Pseudomonas aeruginosa, leading to a diagnosis of EG. Initial antibiotic treatment resulted in partial remission. However, the patient had to be re-admitted due to a relapse 3–4 weeks after the first episode. Finally, the patient was successfully treated with a combined approach consisting of antibiotics, recurrent surgical incisions, and administration of immunoglobulins. Conclusions In conclusion, EG should be considered as a differential diagnosis in immunosuppressed patients presenting with eschar-like skin ulcers. A combined treatment approach seems to be the best choice to achieve clinical cure and avoid relapse.

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“…The occurrence of reduced gammaglobulinemia in CLL patients is more marked with advanced-stage disease and linked with patient age and associated pathologies (91). This occurs in CLL subjects with mutated and unmutated immunoglobulin heavy chain genes (99)(100)(101).…”

Section: Characteristics Of Secondary Immunodeficiency In Patients With Chronic Lymphocytic Leukemiamentioning

confidence: 99%

Secondary Immunodeficiency in Hematological Malignancies: Focus on Multiple Myeloma and Chronic Lymphocytic Leukemia

et al. 2021

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Secondary immunodeficiency is reported in most patients with hematological malignancies such as chronic lymphocytic leukemia and multiple myeloma. The aim of our review was to evaluate the existing literature data on patients with hematological malignancies, with regard to the effect of immunodeficiency on the outcome, the clinical and therapeutic approach, and on the onset of noninfectious complications, including thrombosis, pleural effusion, and orofacial complications. Immunodeficiency in these patients has an intense impact on their risk of infection, in turn increasing morbidity and mortality even years after treatment completion. However, these patients with increased risk of severe infectious diseases could be treated with adequate vaccination coverage, but the vaccines’ administration can be associated with a decreased immune response and an augmented risk of adverse reactions. Probably, immunogenicity of the inactivated is analogous to that of healthy subjects at the moment of vaccination, but it undertakes a gradual weakening over time. However, the dispensation of live attenuated viral vaccines is controversial because of the risk of the activation of vaccine viruses. A particular immunization schedule should be employed according to the clinical and immunological condition of each of these patients to guarantee a constant immune response without any risks to the patients’ health.

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Chronic Lymphocytic Leukemia-Induced Humoral Immunosuppression: A Systematic Review

Cited by 12 publications

References 56 publications

Reasons and consequences of COVID‐19 vaccine failure in patients with chronic lymphocytic leukemia

Reasons and consequences of COVID‐19 vaccine failure in patients with chronic lymphocytic leukemia

An Eschar-like souvenir from a journey to Colombia: Ecthyma gangrenosum as a differential diagnosis of tropical diseases in immunocompromised patients – a case report

Secondary Immunodeficiency in Hematological Malignancies: Focus on Multiple Myeloma and Chronic Lymphocytic Leukemia

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