02 July 2024

Frequent testing for immunoglobulin G (IgG) may reduce the risk of severe infection among some blood cancer patients, researchers have reported.

Regular IgG testing has been found to be effective for patients with chronic lymphocytic leukaemia (CLL) and non-Hodgkin’s lymphomas (NHL), according to a report in Blood Advances.

The findings come from a real-world study of more than 17,000 patients treated at eight hospitals in the area of Boston, Massachusetts, USA, since 2010.

The researchers found “highly variable” clinical practice – only about half of patients underwent testing. Patients should receive immunoglobulin replacement therapy (IgRT) when testing shows low levels of IgG, they say.

The study found that 51% of patients with NHL were tested and 4.7% received replacement therapy. The odds of developing severe infection were reduced by 86% when patients underwent regular testing.

Among those with CLL, 67% were tested and 6.7% received replacement therapy – with a 92% reduction in the odds of severe infection linked to testing.

Researcher Dr Jacob Soumerai, of Massachusetts General Hospital Cancer Center and Harvard Medical School, said:  “Within each disease cohort, patients with three or more IgG tests were more likely to have low IgG detected and also more likely to receive immunoglobulin replacement therapy (IgRT).

“These findings suggest that patients known to have low levels of IgG might be more likely to communicate recurrent minor infections to their haematologists, leading to improved IgRT use.”

Dr Soumerai said: “This underlines the urgent need to establish clear consensus on best practices for IgG testing and IgRT use in patients with CLL and NHL, to reduce recurrent infections in our patients.”


Soumerai JD, Yousif Z, Gift T, Desai R, Huynh L, Ye M, Banatwala A, Clear L, Pinaire M, Belsky G, Hsieh YG, Herrick C, Darnell EP, Duh MS, Sanchirico M, Murphy SN. (2024) “IgG Testing, Immunoglobulin Replacement Therapy, and Infection Outcomes in Patients with CLL or NHL: Real-World Evidence.” Blood Advances, 21 June 2024, doi: 10.1182/bloodadvances.2024013073.

Link: https://ashpublications.org/bloodadvances/article/doi/10.1182/bloodadvances.2024013073/516590/IgG-Testing-Immunoglobulin-Replacement-Therapy-and

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