Abstract
8147 Background MBL deficiency (MBL-D)with an incidence of approximately 30% is probably the most common defect of the innate immune system. With an intact immune system the defect is of limited importance, while during chemotherapy induced-N the MBL-D may result in an increased risk of nfections. Methods The study was a prospective observational one and all pts with haematological malignancies admitted for at least one chemotherapy cycle from Dec. 2001 through Dec. 2003 were eligible. MBL level and genotype, fever, neutrophil counts and signs of infectious episodes were assessed following each chemotherapy cycle. MBL-D was defined as <500 ng/mL. MBL assessments were unknown to investigators during the study. Our objective is to investigate if MBL-B was associated with more frequent and/or severe infections. Poisson regression models were used for analysing counts of infections. Kaplan-Meier estimates and log-rank tests were used for analysing time to event variables. Results Overall 255 pts were eligible for the study. 62 (24%) of the pts had MBL-D, 241 developed N and are the basis of this report. The rate of severe infections during N was higher for the MBL-D group, 4.46/100 days vs. 3.44/100 days (P=0.10) and significantly higher when acute leukemic pts were excluded (4.99/100 days versus 2.96, p=0.01). Time to severe infection based on days of N was significantly shorter in the MBL-D population (median of 10 days compared to 21 days, p=0.05) and the impact of MBL-D was strengthened when acute leukemic pts were excluded (medians of 8 versus 35 days, p=0.01). No difference in the occurrences of febrile N was found between the two groups (P=0.35). Conclusions MBL-D in N haematological pts was associated with more frequent severe infection, especially when acute leukemic pts were excluded. This finding supports the importance of MBL mesurement with intensive monitoring for signs of infection in this group of pts at increased risk and strengthens the hypothesis of MBL replacement therapy. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Natimmune Natimmune Natimmune
Published Version
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