.png){kind=icon}
.png){kind=icon}
Return
Distinct clinical associations of baseline and treatment-emergent hypogammaglobulinemia in diffuse large B-cell lymphoma: a retrospective real-world cohort study
.png){kind=icon}
OA
AI
U
T
S
Ü
E
O
O
L
DOI：10.1007/s00277-026-07169-9.png)
.png){kind=icon}
Original request for help.png){kind=icon}
Share.png){kind=icon}
Save
Abstract
En 中文
Hypogammaglobulinemia is increasingly recognized in B-cell malignancies, but whether its clinical significance differs by timing, present at diagnosis versus developing after treatment, remains unclear in diffuse large B-cell lymphoma (DLBCL). We retrospectively evaluated 181 adults with newly diagnosed DLBCL treated with rituximab-based immunochemotherapy at a tertiary referral center. Hypogammaglobulinemia was defined as serum IgG < 7 g/L and classified as baseline hypogammaglobulinemia (BHG), treatment-emergent hypogammaglobulinemia (TEHG), or absent. Among the study population, 107 patients (59.1%) developed hypogammaglobulinemia, including 30 (16.6%) with BHG and 77 (42.5%) with TEHG. Patients with BHG exhibited a more adverse baseline clinical profile characterized by poorer performance status and higher-risk disease features. Complete response rates differed significantly across groups and were lowest in patients with BHG (73.3%) compared with TEHG (88.3%) and no hypogammaglobulinemia (94.6%) (p = 0.008). BHG was also associated with the poorest survival outcomes, with median progression-free survival (PFS) and overall survival (OS) of 26.4 and 30.9 months, respectively. In multivariable analyses, BHG independently predicted infectious complications but was not an independent predictor of PFS. TEHG was associated with shorter PFS in the primary multivariable model; however, this association was not confirmed in a prespecified 6-month landmark analysis. These findings suggest that BHG and TEHG represent distinct clinical states in DLBCL. While BHG identifies a clinically vulnerable subgroup with increased infection risk and inferior outcomes, the prognostic significance of TEHG should be interpreted cautiously because of non-protocolized monitoring and potential ascertainment bias.
Keywords:
Diffuse large B-cell lymphoma
Hypogammaglobulinemia
Rituximab
Immunochemotherapy
Infection
Prognosis
Survival
Journal
IF:
2.4
Papers:
8.3K
Citations:
8.1K
Organization
Cited Papers