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TOPLINE:

In a 14-year study of 6217 patients with chronic lymphocytic leukemia (CLL), regular immunoglobulin replacement therapy (IgRT) was associated with higher infection rates during treatment periods than during nontreatment periods. Monthly infection-related hospitalizations doubled, while IgRT use quadrupled over the study period.

METHODOLOGY:

• Researchers conducted a retrospective longitudinal analysis of 6217 patients diagnosed with CLL between 2008 and 2022 in Victoria, Australia, using linked hospital and death data.
• Analysis included Kaplan-Meier survival analyses to estimate survival, infection incidence, and IgRT use, while Cox survival analyses explored associations between infections and IgRT in regular prophylactic users.
• Investigators tracked 753 patients (12.1%) who received IgRT, with 524 (8.4%) receiving regular treatment, defined as at least three IgRT sessions within a 5-month period, with no gaps longer than 3 months.

TAKEAWAY:

• Patients experiencing serious infections showed significantly higher mortality rates (0.090; 95% CI, 0.074-0.110) than those without infections (0.008; 95% CI, 0.007-0.009).
• Regular IgRT users demonstrated higher infection incidence during treatment periods (0.056; 95% CI, 0.052-0.060) vs nontreatment periods (0.038; 95% CI, 0.035-0.042).
• Serious infections were strongly associated with IgRT initiation (hazard ratio [HR], 31.91; 95% CI, 24.94-40.82) and cessation (HR, 3.81; 95% CI, 2.71-5.35).
• The median survival time from CLL diagnosis was 10 years, with infection-related hospitalizations doubling, while IgRT use quadrupled over the 14-year follow-up period.

IN PRACTICE:

“Given the increasing use and costs of IgRT, these results highlight the need to evaluate the causal association between IgRT and infections and determine which patient subgroup, and at what point during their disease course, may benefit the most from IgRT treatment. Further research, particularly randomized controlled trials, is needed to fully understand the effectiveness and cost-effectiveness of IgRT in this patient population,” wrote the authors of the study.

SOURCE:

The study was led by Sara Carrillo de Albornoz, School of Public Health and Preventive Medicine, Monash University in Melbourne, Australia. It was published online in Blood Advances.

LIMITATIONS:

According to the authors, the retrospective design and potential selection bias were significant limitations. The study lacked key clinical prognostic factors, disease severity data, and cancer treatment-related information. Additionally, researchers could not stratify patients or adjust for infection risk, particularly underlying hypogammaglobulinemia. The analysis was limited to serious infections, while outpatient infections and oral antibiotic treatments outside of hospital were not captured.

DISCLOSURES:

The study was funded by the Medical Research Future Fund Value-Ig Study. Erica Wood and Zoe McQuilten disclosed receiving grant funding from CSL Behring unrelated to this study and research funding to their institution from Abbvie, Amgen, AstraZeneca, Beigene, Celgene, Janssen, New Zealand Blood Service, Novartis, Sanofi, and Takeda.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.