Immunoglobulin Replacement Not Associated With Fewer Infections in CLL

Among patients with CLL, immunoglobulin replacement therapy is not associated with a reduced risk of serious infections: © stock.adobe.com.

Among patients with CLL, immunoglobulin replacement therapy is not associated with a reduced risk of serious infections: © stock.adobe.com.

Among patients with chronic lymphocytic leukemia (CLL), receiving regular treatment via immunoglobulin replacement therapy is not associated with a reduced risk of serious infections that require hospitalization, researchers have found.

The insight was spotlighted in a story published in the medical journal entitled, Blood Advances.

“To our knowledge, this is the first study to examine long-term, real-world [immunoglobulin replacement therapy] patterns, serious infections and survival in a large cohort of [patients with CLL],” researchers wrote in the study. “Our study highlighted the burden of infections in patients with CLL and the impact on survival. Over the 14-year follow-up period serious infections increased from 1.9% to 3.9%, while [immunoglobulin replacement therapy] use increased from 2% to 8.8%. Among patients receiving [immunoglobulin replacement therapy] at regular intervals, we found a higher incidence of serious infections while on [immunoglobulin replacement therapy] compared to off-treatment periods. Serious infections were associated with [immunoglobulin replacement therapy] initiation, cessation and re-initiation.”

“This is the first large, real-world study to follow patients with CLL who are regularly receiving immunoglobulin replacement,” said lead study author, Sara Carrillo de Albornoz, health economist and PhD candidate at Monash University in Australia. “Given its high cost and variable use in clinical practice, this is a critical issue from a policy, economic, and clinical perspective.”

Albornoz was cited saying this in a news release issued by the American Society of Hematology

Immunoglobulin replacement therapy, according to the news release, is used with the intention of boosting patients’ antibody levels in an attempt to reduce their risk of infection.

“Many of the studies supporting the use of immunoglobulins to reduce infections in patients with blood cancers date back over thirty years, and the treatment for CLL has advanced significantly since then,” Dr. Erica Wood, study author and professor at Monash University, said in the news release. “While immunoglobulins likely do benefit some patients, there remains a critical need to better understand the extent of that benefit, who is most likely to benefit, and how long these patients should be receiving treatment.”

Researchers utilized data from 6,217 patients, of whom 753 (12.1%) received at least one dose of immunoglobulin replacement therapy during an average follow-up period of 6.9 years. During 14 years of follow-up, 35.2% of patients died, with a median time to death from diagnosis of approximately 10 years, according to the news release.

Among patients who received immunoglobulin replacement therapy, 45.9% died during follow-up, with a median survival time of approximately six years from the first treatment. For patients who regular immunoglobulin replacement therapy received immunoglobulins, 46.9% were on treatment from one to five years, and 23.5% received immunoglobulins for more than five years, conditional on follow-up and survival, the news release detailed.

“We not only saw no reduction in infection rates or hospitalizations among patients receiving immunoglobulins, we found that many were on this therapy for extended periods of time,” said Wood. “It’s essential that we evaluate how long these patients remain on treatment and why to avoid unnecessary, prolonged, and expensive therapy of a product in limited supply internationally.”

Because some patients with CLL don’t make enough antibodies to fight infections, they can be vulnerable to repeated lung and/or sinus infections, as the American Cancer Society explained. Patients with low antibodies can receive antibodies from a donor, injected into the patient’s vein intravenously. The American Cancer Society noted that most patients with CLL don’t usually require intravenous immunoglobulins, but if it is given it is done so approximately once a month at first and then less frequently over time.

References

1. “Immunoglobulin use, survival, and infection outcomes in patients with chronic lymphocytic leukemia” by Sara Carrillo De Albornoz et al., Blood Advances.
2. “Immunoglobulin Replacement Therapy Shows No Reduction in Serious Infections for Patients with CLL,” news release, July 31, 2025. https://www.hematology.org/newsroom/press-releases/2025/igrt-shows-no-reduction-in-serious-infections-for-patients-with-cll.
3. “Supportive or Palliative Care for Chronic Lymphocytic Leukemia (CLL),” American Cancer Society. https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/treating/supportive-care.html

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