ASH 2023: How Can Immunoglobulin Replacement Therapy Help CLL Patients?

CLL specialist Dr. Jacob Soumerai from Massachusetts General Hospital Cancer Center shared important research at the ASH 2023 conference about how CLL patients can reduce their risk of infections by receiving immunoglobulin replacement therapy (IgRT). Read about Dr. Soumerai’s study below to learn how this therapy can benefit you as a CLL patient. 

What is Immunoglobulin Replacement Therapy (IgRT)? 

Immunoglobulin replacement therapy (IgRT) is a type of treatment that takes antibodies from healthy donors and gives them to a patient who has low levels of antibodies (sometimes referred to as immunoglobulins). An antibody is an infection-fighting protein, created from B-cells. CLL patients often have low levels of these antibodies. Click here to learn more about the reasons why CLL patients may have lower levels of antibodies compared to healthy individuals. 

The types of immunoglobulin replacement therapies include: 

• Intravenous Immunoglobulin (IVIG): The donor antibodies are administered intravenously. This is the most common type of immunoglobulin replacement therapy. Click here to learn more about IVIG and CLL. 
• Subcutaneous Immunoglobulin (SCIG): The donor antibodies are injected under the skin. 
• Intramuscular Immunoglobulin (IMIG): The donor antibodies are injected into a muscle. 
• Hybrid Immunoglobulin Therapy: This is a combination of administering the antibodies intravenously (IVIG) and through a skin injection (SCIG). 

About Dr. Soumerai’s Study 

Dr. Soumerai analyzed CLL patient records from 2010 to the present. He reviewed how many patients received the immunoglobulin G test. Immunoglobulin G (IgG) is the most common type of antibody that patients have. When IgG is low, it can result in patients getting more infections. The diagnosis of low IgG is sometimes referred to as hypogammaglobulinemia (HGG). Patients diagnosed with HGG have 500 or less milligrams of IgG per deciliter of blood (mg/dL). 

Dr. Soumerai then compared the percentage of patients who had HGG before and after immunoglobulin replacement therapy. He found that the therapy helped decrease the number of CLL patients who had HGG. The percentage of CLL patients who had HGG before the therapy was 72.8%. The percentage of CLL patients who had HGG three months following the therapy decreased to 33.8%. 

Dr. Soumerai also found that immunoglobulin replacement therapy greatly helped decrease CLL patients’ risk of getting an infection. This in turn reduced the amount of infection-fighting medicines patients had to take like antivirals, antibiotics, and antifungals. 

Dr. Soumerai did not mention in his research which immunoglobulin replacement therapy (IgRT) was used to treat the CLL patients, however, it is highly likely that the therapy was IVIG because of how commonly this type of administration is used for CLL patients. 

Why is This Important for CLL Patients? 

As a CLL patient, infections can be a big deal. Although most resolve on their own with time, it may take CLL patients longer to resolve an infection than it does for someone without CLL. Additionally, Dr. Soumerai explained that in reports of CLL patients who pass away, half of the time the cause was due to an  infection. 

While this seems like a scary statistic, educating yourself about the reality of the situation can help prepare you with the foundational knowledge you need to be able to advocate for yourself. Understanding Dr. Soumerai’s research findings can help you: 

• Ensure your doctor checks your antibody levels (immunoglobulin test)
• Discuss with your doctor if immunoglobulin replacement therapy like IVIG is right for you 

Another helpful resource that CLL patients can use to reduce their risk of getting an infection is information that was presented by CLL specialist Dr. Meghan Thompson at a recent event hosted by HealthTree. We invite you to read the event summary or watch the event’s recording by clicking on the link below: 

Infection Prevention for CLL Patients with Dr. Meghan Thompson

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