Serum immunoglobulin levels in patients with lymphoproliferative diseases in Erbil, Kurdistan region, Iraq

Karwan Bahram Maulood; Abdulkadir Aziz Alnaqshabandi

doi:10.15218/zjms.2017.053

Authors

Karwan Bahram Maulood Directorate of Health, Erbil, Iraq.
Abdulkadir Aziz Alnaqshabandi Department of Clinical Analysis, College of Pharmacy, Hawler Medical University, Erbil, Iraq.

DOI:

https://doi.org/10.15218/zjms.2017.053

Keywords:

Lymphoproliferative disorders, Immunoglobulin, Paraprotein

Abstract

Background and objectives: Lymphoproliferative neoplasms are among the commonest human neoplasia. Immune dysregulation is frequently associated with many of these diseases, particularly those related to B-cell origin. This study aimed to find out the immunological status of newly diagnosed patients with lymphoproliferative disorders.

Methods: This study was carried out in Erbil province during the period from November 2010 to April 2011. Fifty two newly diagnosed patients (34 males and 18 females) with lymphoproliferative disorders referred to Nnakaly Hospital for blood disease and 20 healthy control subjects had been included in this study. Determination of immunoglobulin subclasses by radial immunodiffusion in addition serum protein electrophoresis has been performed for each sample for the detection of monoclonal bands.

Results: Serum IgM and IgA level were decreased in all groups of patients with different lymphoproliferative disorders compared to control group. Serum IgG level showed insignificant reduction in acute lymphocytic leukemia and chronic lymphocytic leukemia patients, but it was increased in non Hodgkin lymphoma, Hodgkin lymphoma and multiple myeloma patients. Paraproteinemia had been seen in all patients with multiple myeloma while only 10% of chronic lymphocytic leukemia and non Hodgkin lymphoma showed paraproteinemia. No M-band had been noticed in acute lymphocytic leukemia and Hodgkin lymphoma.

Conclusion: There were some conflicting data regarding serum immunoglobulin levels in newly diagnosed patients with lymphoproliferative disorders in Erbil, Iraq.

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References

Jemal A, Siegel R, Ward E, Murray T, Xu J, Smigal C, et al. Cancer statistics. CA Cancer J Clin 2006; 56:106-30.

Kaushansky K, Lichtman M, Kipps T, Seligsohn U, Prchal J. Williams Hematology. 8th ed. New York: McGraw-Hill; 2010. p. 272-98.

Malik AR, Tayyib M, Tasnim T, Ditta A, Chaudhary NA. Serum immunoglobulin levels in patients with non-Hodgkin`s lymphoma. Pak Postgrad Med J 2002; 13(3):114-9.

Raab MS, Podar K, Breitkreutz I. Multiple myeloma. Lancet 2009; 374:324-9.

Martins G, Calame K. Regulation and functions of Blimp-1 in T and B lymphocytes. Annu Rev Immunol 2008; 26:133-69.

Kiani-amin M, Daneshi M, Ayazi P, Mohammadian Sh, Rezaeiz N. Serum immunoglobulin levels in splenectomized and non-splenectomized patients with major beta-Thalassemia. Iran J Pediatr 2011; 21(1):95-8.

Amin A, Jalali S, Amin R. Evaluation of the serum levels of immunoglobulin and complements factors in Beta thalassemia major patients in southern Iran. Iran J Immunol 2005; 2(4):220-5.

Mashhadi MA, Khazaei HA, Narouie B, Niazi AA, Moazzami K, Khademi R, et al. Abnormal Immunoglobulin Levels in Iranian Patients with Hematologic Malignancies. Shiraz E Medical Journal 2009; 10(3): 120-5.

Martin I, Arce A, Cruz O, Estella J, Martín MA. Humoral immunity in pediatric patients with acute lymphoblastic leukaemia. AllergolImmunopathol (Madr) 2003; 31(6):303-10.

Shimizu Y, Hendershot LM.Organization of the functions and components of the endoplasmic reticulum.AdvExp Med Biol 2007; 594:37-46.

Borghesi L, Milcarek C. From B cell to plasma cell: regulation of V(D)J recombination and antibody secretion. Immunol Res 2006; 36(1–3):27-32.

Ahluwalia J, Datta U, Marwaha RK. Immune function in splenectomizedthalassemic children. Indian J Pediatr 2002; 67(12):871-6.

Parker D, Alison DL, Barnard DL, Child JA, Dovey G, Farish J, et al. Prognosis in low grade non-Hodgkin's lymphoma: relevance of the number of sites involved, absolute lymphocyte count and serum immunoglobulin level. HematolOncol 1994; 12(1):15-27.

Winkelstein A. Differential effects of immunosuppressants on lymphocyte function. J Clin Invest 1973; 52:2293-9.

Stevenson HC, Fauci AS. Immunosuppression Secondary to Pharmacologic Agents: Primary and Secondary Immunodeficiency Disorder. New York: Churchill Livingston; 1983.

Fauci AS, Pratt KR, Whalen G. Intrinsic B-cell defect in the immunoglobulin deficiency of chronic lymphocytic leukemia (Abstr). CIinRes 1977; 25:482.

Han T, Dadey B. In vitro functional studies of mononuclear cells in patients with CLL Evidence for functionally normal T-lymphocytes and monocytes and abnormal B-lymphocytes. Cancer 1979; 43:109- 17.

Hersey P, Wotherspoon J, Reid G, Gunz FW. Hypogammaglobulinemia associated with abnormalities of both B- and T-lymphocytes in patients with chronic lymphocytic leukemia. Clin ExpImmunol 1980; 39; 698-707.

Lamberson HV, Davey FR, Schreck CM, Zamkoff K, Kurec AS .Lymphocyte response to pokeweed mitogen in chronic lymphocytic leukemia. Cancer 1984; 53:2481-6.

Pereira RS, Platts-Mills TAE. Lymphocyte subsets in hypogammaglobulinemia. Clin Hematol 1982; 1:1589-605.

Okpala IE, Salimonu LS. The prognostic value of serum Immunoglobulin G and immune complex levels in acute lymphoblastic leukemia. Cent AfrJ.Med 1991; 37:153-6.

Potapnev MP, Belevtsev MV, Bortkevich LG, Grinev VV, Martsev SP, Kravchuk ZI, et al. Significance of serum immunoglobulin G for leukocytosis and prognosis in childhood B-lineage acute lymphoblastic leukemia. Pediatr Blood Cancer 2004; 42(5):421-6.

Sorensen RU, Moore C. Antibody deficiency syndromes. Pediatr Clin North Am 2000; 47:1225-52.

Davies EG .Immunodeficiency. In: Campbell AGM, Mc Intosh N (Eds). Textbook of Pediatrics. 5th ed. New York: Livingstone; 1989. P. 1231-70.

Leikin S, Miller D, Sather H, Albo V, Esber E, Johnson A. Hammond D. Immunologic evaluation in the prognosis of acute lymphoblastic leukemia. A report from Childrens Cancer Study Group. Blood 1981; 58(3):501-8.

Swerdlow S. International Agency for Research on C, World Health O. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon France: International Agency for Research on Cancer; 2008.

Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Döhner H, et al. Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: areport from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines. Blood 2008; 111(12):5446-56.

Natasa E, Andrija B, Vesna M, Gradimir J. Prognostic significance of serum immunoglobulins in B- chronic lymphocytic leukemia. Arch Oncol 2001; 9(2):79-82.

Rozman C. Montserrat E, Rodríguez-Fernández JM, Ayats R, Vallespí T, Parody R, Ríos A, Prados D, Morey M, Gomis F. Bone Marrow Histologic Pattern-The Best Single Prognostic Parameter in Chronic Lymphocytic Leukemia: A Multivariate Survival Analysis of 329 Cases. Blood 1984; 64(3):642-8.

Sampalo A, Navas G, Medina F, Segundo C, Camara C, Brieva AJ. Chronic lymphocytic leukemia B cells inhibit spontaneous Ig production by autologous bone marrow cells: role of CD95-CD95L. Blood 2000; 96:3168-74.

Pezzoli A, Pascali E. Monoclonal Bence Jones proteinuria in chronic lymphocytic leukaemia. Scand J Haematol 1986; 36:18-24.

Ellison-Loschmann L, Benavente Y, Douwes J, Buendia E, Font R, Alvaro T, et al. Immunoglobulin E levels and risk of lymphoma in a case-control study in Spain. Cancer Epidemiol Biomarkers Prev 2007; 16:1492-8.

Grulich AE, Vajdic CM, Riminton S, Hughes AM, Kricker A, Armstrong BK et al. Re: atopy and risk of non-Hodgkin lymphoma. J Natl Cancer Inst 2007; 99:1417-22.

Robert J. Biggar, M C, Klaus R, Karin E. Immunoglobulin subclass levels in patients with non-Hodgkin lymphoma. Int J Cancer 2009; 124:2616-20.

Biggar RJ, Christiansen M, Rostgaard K, Smedby KE, Adami HO, Glimelius B, et al. Immunoglobulin subclass levels in patients with non-Hodgkin lymphoma. Int J Cancer 2009; 124:2616-20.

Ana P, Koloni S, Radi-Krito D, Dominis M, Branimir J. Serum Immunoglobulins in non-Hodgkin’s Lymphoma Patients. Coll. Antropol 2010; 34(2):407-11.

Martin W, Abraham R, Shanafelt T, Clark RJ, Bone N, Geyer SM, et al. Serum-free light chain-a new biomarker for patients with B-cell non-Hodgkin lymphoma and chronic lymphocytic leukemia. Translational Research 2007; 149:231-5.

Melbye M, Smedby KE, Lehtinen T, Rostgaard K, Glimelius B, Munksgaard L, et al. Atopy and risk of non-Hodgkin lymphomaJ Natl Cancer Inst 2007; 99:158-66.

Ostojic-Kolonic S, Prasek-Kudrna K, Roso V, Radic-Kristo D, Planinc- Peraica A, Dzebro S, et al. Value of fine-needle aspiration cytology in diagnosis of Hodgkin's lymphoma and anaplastic large cell lymphoma: one centre experience. CollAntropol 2010; 34:75-9.

Pascali E, Pezzoli A. The clinical spectrum of pure Bence Jones proteinuria. A study of 66 patients. Cancer 1988; 62:2408-15.

Kennedy-Nasser AA, Bollard CM, Rooney CM. Adoptive immunotherapy for Hodgkin’s lymphoma. Int J Hematol 2006; 83:385-90.

Robert A, Morie A, Thomas E, John A, Martha Q , Angela D, et al. Review of 1027 Patients With Newly Diagnosed Multiple Myeloma. Mayo Clin Proc 2003; 78:21-33.

Poppema S, PottersM, Visser L, Van Den B. Immune escape mechanisms in Hodgkin’s disease. Ann Oncol 1998; 9(Suppl 5):S21-4.

Obianwu I, Onykwere T, Ochene S. Immunoglobulin level in some myeloproliferative and lymphoproliferative disorders in Enugu, Nigeria. Research Journal of Medical Sciences 2007; 1(2):132-4.

Nepal AK, Shakya PR, Gelal B, Lal Das BK, Shrestha BP, Lamsal M, et al. Biochemical profile of Multiple Myeloma in the patients visiting bpkihs as diagnosed by agarose gel electrophoresis. Health Renaissance 2010; 8(2):122-5.

Harousseau JL, Dreyling M. Multiple myeloma: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol 2009; 20(Suppl 4):97-9.

Mills KHG, Cawley JC. Abnormal monoclonal antibody-defined helperisuppressor T cell populations in niultiplc myeloma. Relationship to treatment and clinical stage. Br J Haematol1983; S3:271-4.