Skip to main content
SpringerLink
Log in

Immune deficiencies in chronic lymphocytic leukemia and multiple myeloma

  • Published:
Clinical Reviews in Allergy Aims and scope Submit manuscript

Abstract

Research related to the etiology and mechanisms of immunodeficiency in B-cell neoplasms has helped to identify prophylactic and therapeutic measures to manage infections, which remain the leading cause of death despite antimicrobial therapy. In both CLL and multiple myeloma, defective antibody formation is a key risk factor for developing infection. Preliminary data indicate that IVIG replacement therapy is an effective and safe means to improve the antibody profile and reduce the incidence of infection in some patients with either of these B-cell malignancies. Replacement therapy alone is not sufficient. However, in a subset of affected patients who experience recurrent infections, IVIGs may be beneficial as adjunctive therapy when used in conjunction with chemotherapy for the underlying malignancy and antibiotic therapy for acute infections. Further studies are needed to better define their role and to identify those patients who are most likely to benefit from IVIGs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cooper, M. D. (1987),N. Engl. J. Med. 17, 1452–1456.

    Google Scholar 

  2. Fu, S. M., Winchester, R. J., and Kunkel, H. G. (1975),J. Immunol. 114, 250–252.

    PubMed  CAS  Google Scholar 

  3. Salsano, F., Frøland, S. S., Natvig, J. B., and Michaelsen, T. E. (1974),Scand. J. Immunol. 3, 841–846.

    Article  PubMed  CAS  Google Scholar 

  4. Ternynck, T., Dighiero, G., Folleqou, J., and Binet, J.-L.(1974),Blood 43, 789–795.

    PubMed  CAS  Google Scholar 

  5. Gale, R. P. and Foon, K. A. (1987),Sem. Hematol. 24, 209–229.

    CAS  Google Scholar 

  6. Gale, R. P. and Foon, K. A. (1985),Ann. Intern. Med. 103, 101–120.

    PubMed  CAS  Google Scholar 

  7. Caligaris-Cappio, F. and Janossy, G. (1985),Sem. Hematol. 22, 1–12.

    CAS  Google Scholar 

  8. Freedman, A. S. and Nadler L. M. (1987),Sem. Hematol. 24, 230–239.

    CAS  Google Scholar 

  9. Anderson, K. C., Bates, M. P., Slaughenhoupt, B. L., Pinkus, G. S., Schlossman, S. F., and Nadler, L. M. (1984),Blood 63, 1424–1433.

    PubMed  CAS  Google Scholar 

  10. Boumsell, L., Coppin, H., Pham, D., Raynal, B., Lemerle, J., Dausset, J., and Bernard, A. (1980),J. Exp. Med. 152, 229–234.

    Article  PubMed  CAS  Google Scholar 

  11. Caligaris-Cappio, F., Gobbi, M., Bofill., M., and Janossy, G. (1982),J. Exp. Med. 155, 623–628.

    Article  PubMed  CAS  Google Scholar 

  12. Gadol, N. and Ault, K. A. (1986),Immunol. Rev. 93, 23–34.

    Article  PubMed  CAS  Google Scholar 

  13. Hayakawa, K., Hardy, R. R., Parks, D. R., and Herzenberg, L. A. (1983),J. Exp.Med. 157, 202–218.

    Article  PubMed  CAS  Google Scholar 

  14. Herzenberg, L. A., Stall, A. M., Lalor, P. A., Sidman, C., Moore, W. A., Parks, D. R., and Herzenberg, L. A. (1986),Immunol. Rev. 93, 81–102.

    Article  PubMed  CAS  Google Scholar 

  15. Antin, J. H., Emerson, S. G., Martin, P., Gadol, N., and Ault, K. A. (1986),J. Immunol. 136, 505–510.

    PubMed  CAS  Google Scholar 

  16. Ault, K. A., Antin, J. H., Ginsburg, D., Orkin, S. H., Rappeport, J. M., Keohan, M. L., Martin, P., and Smith, B. R. (1985),J. Exp. Med. 161, 1483–1502.

    Article  PubMed  CAS  Google Scholar 

  17. Whelan, C. A., Willoughby, R., and McCann, S. R. (1983),Acta Haematol. 69, 217–223.

    PubMed  CAS  Google Scholar 

  18. Slungaard, A. and Smith, M. J. (1974),Scand. J. Haematol. 12, 112–116.

    PubMed  CAS  Google Scholar 

  19. Whiteside, T. L., Winkelstein, A., and Rabin, B. S. (1977),Cancer 39, 1109–1118.

    Article  PubMed  CAS  Google Scholar 

  20. Montserrat, E., Marques-Pereira, J. P., Gallart, M. T., and Rozman, C. (1984),Cancer 54, 447–451.

    Article  PubMed  CAS  Google Scholar 

  21. Chapel, H. M. and Bunch, C. (1987),Sem. Hematol. 24, 291–296.

    CAS  Google Scholar 

  22. Fairley, G. H. and Scott, R. B. (1961),Br. Med. J. 4, 920–924.

    Google Scholar 

  23. Ben-Bassat, I., Many, A., Modan, M., Peretz, C., and Ramot, B. (1979),Am. J. Med. Sci. 278, 4–9.

    Article  PubMed  CAS  Google Scholar 

  24. Arnold, C. and McPhedran, P. (1985),Blood 66, 170A.

    Google Scholar 

  25. Rozman, C., Montserrat, E., and Vinolas, N. (1988),Cancer 61, 279–283.

    Article  PubMed  CAS  Google Scholar 

  26. Foa, R., Catovsky, D., Brozovic, M., Marsh, G., Ooyirilangkumaran, T., Cherchi, M., and Galton, D. A. G. (1979),Cancer 44, 483–487.

    Article  PubMed  CAS  Google Scholar 

  27. Cone, L. and Uhr, J. W. (1964),J. Clin. Invest. 43, 2241–2248.

    Article  PubMed  CAS  Google Scholar 

  28. Qian, G.-X., Fu, S. M., Solanki, D. L., and Rai, K. R. (1984),J. Immunol. 133, 3396–3400.

    PubMed  CAS  Google Scholar 

  29. Hamblin, T. J., Oscier, D. G., and Young, B. J. (1986),J. Clin. Pathol. 39, 713–716.

    Article  PubMed  CAS  Google Scholar 

  30. Catovsky, D., Miliani, E., Okos, A., and Galton, D. A. (1974),Lancet 2, 751–752.

    Article  PubMed  CAS  Google Scholar 

  31. Kay, N. E., Oken, M. M., and Perri, R. T. (1983),J. Clin. Oncol. 1, 810–816.

    PubMed  CAS  Google Scholar 

  32. Keller, R. H., Blake, D. G., Lyman, S., and Siebenlist, R. (1981),J. Clin. Lab. Immunol. 6, 201–209.

    PubMed  CAS  Google Scholar 

  33. Perri, R. T. and Kay, N. E. (1986),Am. J. Hematol. 22, 55–61.

    Article  PubMed  CAS  Google Scholar 

  34. Foa, R., Fierro, M. T., Lusso, P., Raspadori, D., Ferrando, M. L., Matera, L., Malavasi, F., and Lauria, F. (1986),Br. J. Haematol. 62, 151–154.

    Article  PubMed  CAS  Google Scholar 

  35. Platsoucas, C. D., Fernandes, G., Gupta, S. L., Kempin, S., Clarkson, B., Good, R. A., and Gupta, S. (1980),J. Immunol. 125, 1216–1223.

    PubMed  CAS  Google Scholar 

  36. Ziegler, H.-W., Kay, N. E., and Zarling, J. M. (1981),Int. J. Cancer 27, 321–327.

    Article  PubMed  CAS  Google Scholar 

  37. Potter, M. (1971),N. Engl. J. Med. 284, 831–838.

    PubMed  CAS  Google Scholar 

  38. Birgens, H. S., Espersen, F., Hertz, J. P., Pedersen, F. K., and Drivsholm, A. (1983),Scand. J. Haematol. 30, 324–330.

    PubMed  CAS  Google Scholar 

  39. Pruzanski, W., Gidon, M. S., and Roy, A. (1980),Clin. Immunol Immunopathol. 17, 280–286.

    Article  PubMed  CAS  Google Scholar 

  40. Theml, H. and Ziegler-Heitbrock, H. W. L. (1984),Cancer Res. 93, 240–258.

    CAS  Google Scholar 

  41. Chapel, H. M. (Gale, R. P. and Rai, K. R., eds.),Chronic Lymphocytic Leukemia: Recent Progress and Future Direction. Alan R. Liss, New York (1987). pp. 383–389.

    Google Scholar 

  42. Kunicka, J. E. and Platsoucas, C. D. (1986),Leukemia Res. 10, 1101–1107.

    Article  CAS  Google Scholar 

  43. Moore, J. S., Prystowsky, M. B., Hoover, R. G., Besa, E. C., and Nowell, P. C. (1988),Blood 71, 1012–1020.

    PubMed  CAS  Google Scholar 

  44. Han, T., Ozer, H., Henderson, E. S., Dady, B., Nussbaum-Blumenson, A., and Barcos, M. (1981),Blood 58, 1182–1189.

    PubMed  CAS  Google Scholar 

  45. Arai, S., Yamamoto, H., Itoh, K., and Kumagai, K. (1983),J. Immunol. 131, 651D657.

    Google Scholar 

  46. Clement, L. T., Grossi, C. G., and Gartland, G. L. (1984),J. Immunol. 133, 2461–2468.

    PubMed  CAS  Google Scholar 

  47. Mangan, K. F., Hartnett, M. E., Matis, S. A., Winkelstein, A., and Abo, T. (1984),Blood 63, 260–269.

    PubMed  CAS  Google Scholar 

  48. Hansson, M., Beran, M., Andersson, B., and Kiessling, R. (1982),J. Immunol. 129, 126–132.

    PubMed  CAS  Google Scholar 

  49. Holmberg, L. A., Miller, B. A., and Ault, K. A. (1984),J. Immunol. 133, 2933–2939.

    PubMed  CAS  Google Scholar 

  50. Kay, N. E. and Perri, R. T. (1989),Blood 73, 1016–1019.

    PubMed  CAS  Google Scholar 

  51. Kunicka, J. and Platsoucas, C. D. (1988),Scand. J. Immunol. 28, 1–10.

    Article  PubMed  CAS  Google Scholar 

  52. Dighiero, G. (1987),Sem. Hematol. 24, 240–251.

    CAS  Google Scholar 

  53. Broder, S., Humphrey, R., Durm, M., Blackman, M., Meade, B., Goldman, C., Strober, W., and Waldmann, T. (1975),N. Engl. J. Med. 293, 887–892.

    PubMed  CAS  Google Scholar 

  54. Ullrich, S. and Zolla-Pazner, S. (1982),Clin. Hematol. 11, 87–111.

    CAS  Google Scholar 

  55. Jacobson, D. R. and Zolla-Pazner, S. (1986),Semin. Oncol. 13, 282–290.

    PubMed  CAS  Google Scholar 

  56. Berman, J. E. and Zolla-Pazner, S. (1985),J. Immunol. 134, 2872–2878.

    PubMed  CAS  Google Scholar 

  57. Dillman, R. O., Royston, I., Meserve, B. L., and Griffiths, J. C. (1981),Cancer 48, 2211–2217.

    Article  PubMed  CAS  Google Scholar 

  58. Pilarski, L. M., Mant, M. J., Ruether, B. A., and Beich, K. A. (1984),J. Clin. Invest. 74, 1301–1306.

    Article  PubMed  CAS  Google Scholar 

  59. Pilarski, L. M., Andrews, D. J., Mant, M. J., and Ruether, B. A. (1986),J. Clin. Immunol. 6, 491–501.

    Article  PubMed  CAS  Google Scholar 

  60. Pilarski, L. M., Mant, M. J., and Ruether, B. (1985),Blood 66, 416–422.

    PubMed  CAS  Google Scholar 

  61. Paglieroni, T. and MacKenzie, M. R. (1977),J. Clin. Invest. 59, 1120–1133.

    Article  PubMed  CAS  Google Scholar 

  62. Ozer, H., Han, T., Henderson, E. S., Nussbaum, A., and Sheedy, D. (1981),J. Clin. Invest. 67, 779–789.

    Article  PubMed  CAS  Google Scholar 

  63. Perri, R. T., Oken, M. M., and Kay, N. E. (1982),J. Lab. Clin. Med. 99, 512–519.

    PubMed  CAS  Google Scholar 

  64. Pezzutto, A., Semenzato, G., Agostini, C., Raimondi, R., and Gasparotto, G. (1981),Scand. J. Haematol. 28, 333–338.

    Google Scholar 

  65. Bergmann, L., Mitrou, P. S., Weber, K. C., and Kelker, W. (1984),Clin. Immunol. Immunother. 17, 112–116.

    CAS  Google Scholar 

  66. Serra, H. M., Mant, M. J., Ruether, B. A., Ledbetter, J. A, and Pilarski, L. M. (1988),J. Clin. Immunol. 8, 259–265.

    Article  PubMed  CAS  Google Scholar 

  67. Theml, H., Bergmann, H., and Rastetter, J. (1982), Therapie Bsartiger Blutkrankheiten (Scheurten, P. G. and Pees, H. W., eds.), Springer-Verlag, Berlin.

    Google Scholar 

  68. Shaw, R. K., Szwed, C., Boggs, D. R., Fahey, J. L., Frei, E., Morrison, E., and Utz, J. P. (1960),Arch. Intern. Med. 108, 467–478.

    Google Scholar 

  69. Bunch, C. (1987),Chronic Lymphocytic Leukemia: Recent Progress and Future Direction (Gale, R. P. and Rai, K. R., eds.), Alan R. Liss, New York, pp. 373–381.

    Google Scholar 

  70. Kyle, R. A. (1975),Mayo Clin. Proc. 50, 29–40.

    PubMed  CAS  Google Scholar 

  71. Twomey, J. J. (1973),Arch. Intern. Med. 132, 562–565.

    Article  PubMed  CAS  Google Scholar 

  72. Shaikh, B. K. S., Lombard, R. M., Appelbaum, P. C., and Bentz, M. S. (1982),Oncology 39, 78–82.

    Article  PubMed  CAS  Google Scholar 

  73. Fahey, J. L., Scoggins, R., Utz, J. P., and Szwed, C. F. (1963),Am. J. Med. 35, 698–707.

    Article  PubMed  CAS  Google Scholar 

  74. Perri, R. T., Hebbel, R. K. P., and Oken, M. M. (1981),Am. J. Med. 71, 935–940.

    Article  PubMed  CAS  Google Scholar 

  75. Espersen, F., Birgens, H. S., Hertz, J. B., and Drivsholm, A. (1984),Scand. J. Infect. Dis. 16, 169–173.

    Article  PubMed  CAS  Google Scholar 

  76. Doughney, K. B., Williams, D. M., and Penn, R. L. (1988),South. Med. J. 81, 855–858.

    Article  PubMed  CAS  Google Scholar 

  77. Savage, D. G., Lindenbaum, J., and Garrett, T. J. (1982),Ann. Intern. Med. 96, 47–50.

    PubMed  CAS  Google Scholar 

  78. Fink, P. C. and Galanos, C. (1985),Immunobiology 169, 1–10.

    PubMed  CAS  Google Scholar 

  79. Stiehm, E. R., Ashida, E., Kim, K. S., Winston, D. J., Haas, A., and Gale, R. P. (1987),Ann. Intern. Med. 107, 367–382.

    PubMed  CAS  Google Scholar 

  80. Roifman, C. M., Lederman, H. M., and Gelfand, E. W. (1985),Intravenous Immunoglobulins. Royal Society of Medicine International Congress and Symposium Series, no. 84 (Waters, A. H. and Webster, A. D. B., eds.), Royal Society of Medicine, London, pp. 41–46.

    Google Scholar 

  81. Webster, A. D. B. and Lever, A. M. L. (1986),Clinical Use of Intravenous Immunoglobulins (Morell, A. and Nydegger, U. E., eds.), Academic Press, London, pp. 67–75.

    Google Scholar 

  82. Yap, P. L., Lightwood, J., and McClelland, D. B. L. (1985),Intravenous Immunoglobulins. Royal Society of Medicine International Congress and Symposium Series, no. 84 (Waters, A. H. and Webster, A. D. B., eds.), Royal Society of Medicine, London, pp. 31–39.

    Google Scholar 

  83. Cooperative Group for the Study of Immunoglobulin in Chronic Lymphocytic Leukemia (1988),N. Engl. J. Med. 319, 902–907.

    Google Scholar 

  84. Besa, E. C. (1984),Am. J. Med. 76 (3A), 209–218.

    Article  PubMed  CAS  Google Scholar 

  85. Ritch, P. S. and Anderson, T. (1987),Cancer 60, 2637–2640.

    Article  PubMed  CAS  Google Scholar 

  86. Besa, E. C. (1988),Am. J. Med. 84, 691–698.

    Article  PubMed  CAS  Google Scholar 

  87. Bussel, J. (1986),Vox Sang. 51 (suppl. 2), 69–73.

    Google Scholar 

  88. Clauvel, J. P., Vainchenker, W., Herrera, A., Dellagi, K., Vinci, G., Tabilio, A., and Lacombe, C. (1983),Br. J. Hematol. 55, 380–382.

    Article  CAS  Google Scholar 

  89. McGuire, W. A., Yang, H. H., Bruno, E., Brandt, J., Briddell, R., Coates, T. D., and Hoffman, R. (1987),N. Engl. J. Med. 317, 1004–1008.

    PubMed  CAS  Google Scholar 

  90. Salmon, S. E., Samal, B. A., Hayes, D. M., Hosley, H., Miller, S. P., and Schilling, A. (1967),N. Engl. J. Med. 277, 1336–1340.

    PubMed  CAS  Google Scholar 

  91. Gordon, D. S., Hearn, E. B., Spira, T. J., Reimer, C. B., Phillips, D. J., and Schable, C. (1984),Am. J. Med. 76 (3A), 111–116.

    Article  PubMed  CAS  Google Scholar 

  92. Schedel, I. (1986),Clinical Use of Intravenous Immunoglobulins (Morell, A. and Nydegger, U. E., eds.), Academic Press, London, pp. 123–132.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Montefiore University Hospital, 3459 Fifth Avenue, 15213, Pittsburgh, PA

    Alan Winkelstein

  2. PharmD, Pomona, NY

    P. Susan Jordan

Authors
  1. Alan Winkelstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Susan Jordan
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Winkelstein, A., Jordan, P.S. Immune deficiencies in chronic lymphocytic leukemia and multiple myeloma. Clinical Reviews in Allergy 10, 39–58 (1992). https://doi.org/10.1007/BF02914369

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02914369

Keywords

Search

Navigation