PB2377 SECONDARY HYPOGAMMAGLOBULINEMIA AFTER HIGH DOSE CHEMOTHERAPY WITH AUTOLOGOUS STEM CELL TRANSPLANTATION FOR LYMPHOMA

Abstract

Background:Secondary hypogammaglobulinemia is associated with hematological malignancy, particularly related to lymphoid malignancy. Other than malignancy itself, treatments induce iatrogenic hypogammaglobulinemia. In standard, eligible patients with advanced lymphoma receive high dose chemotherapy with autologous stem cell transplantation (HDT/ASCT). However, frequency and risk of hypogammaglobulinemia in auto‐setting is unknown.Aims:To clarify frequency and risk of hypogammaglobulinemia in auto‐setting.Methods:We retrospectively analyzed 101 patients with advanced lymphoma who received HDT/ASCT at Kansai Medical University Hospital and Kansai Medical University Medical Center from August 2006 to September 2018. All patients received MEAM regimen with/without rituximab as a conditioning.Results:Median age was 59(24‐71) y/o. Among 101 patients, 92% of patients(n = 93) was measured immunoglobulin levels routinely. 52% of patients(n = 53) had hypogammaglobulinemia(IgG < 700 mg/dl) and 25%(n = 25) of patients remains hypogammaglobulinemia presently. 14 patients recovered from hypogammaglobulinemia. Median period to recovery was 28(0.7‐56.8)months. Among the patients developed hypogammaglobulinemia, 87% was with B cell lymphoma, 9% with T cell lymphoma and 4% with Hodgkin lymphoma. Severe infection(≥grade3) was seen in 16 patients. The most frequent infection was bacterial infection unknown species(n = 5), followed HBV reactivation(n = 3) and Herpes zoster(n = 3), and BKV(n = 2).Summary/Conclusion:52% of patients had hypogammaglobulinemia after HDT/ASCT, which was not only with B cell lymphoma but also with T cell and Hodgkin lymphoma. Median period of immunoglobulin recover is over one year. Addition to common bacterial infections, we should be careful about virus infections.