Immunoglobulinopathies in patients with angioimmunoblastic T-cell lymphoma


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Abstract

Contex. Angioimmunoblastic T-cell lymphoma (AITL) is a rare form of non-Hodgkins lymphoma, characterized by generalized lymphadenopathy, hepatosplenomegaly and dysproteinemia. Hypergammaglobulinaemia is revealed in 50-83% pts with AITL. However, the characteristics of immunoglobulinopathies observed in AITL are scarce. Objective: The aim of the study was to characterize quantitative and qualitative immunoglobulinopathies in patients with AITL at the onset of the disease. Patients and methods. 55 patients with newly diagnosed AITL were enrolled in the study, the male/female ratio was 30/25; median age was 61 (29-81) years. Diagnosis was based on standard WHO criteria. Immunochemical studies of blood serum included serum protein electrophoresis/immunofixation, nephelometric quantification of total immunoglobulins, serum free light chain assay. Results. Quantitative and qualitative immunoglobulinopathies were determined in 49 (89,1%) of 55 pts. Quantitative immunoglobulinopathies were revealed in 47 (85.5%) of 55 cases, qualitative - in 14 (25,5%). Combination quantitative and qualitative immunoglobulinopathies was observed in 12 (21,8%) of 55 pts. The detected immunoglobulinopathies were divided into 4 groups: polyclonal hypergammaglobulinaemia, hypogammaglobulinaemia, oligoclonal gammapathy, and monoclonal gammapathy. Polyclonal hypergammaglobulinaemia was marked in 41 (74.5%) of 55 pts, elevated level of IgG was determined in 27 (49,15%) of 55 cases, IgM - in 18 (32,7%) and IgA - in 21 (38.2%). Interestingly, polyclonal IgE hypergammaglobulinaemia was detected in 12 (48,0%) of 25 cases of performed studies. Hypogammaglobulinaemia was detected in 8 (14,5%) of 55 cases. Oligoclonal gammapathy was determined in 4 (7.3%) of 55 pts. Monoclonal gammapathy was revealed in 11 (20,0%) of 55 cases. The amount of monoclonal immunoglobulin varied from 2.6 to 14.1 g/l. Monoclonal immunoglobulin Gk was detected in 5 of 11 pts, Gλ - in 2, Mλ - in 2, Mk - in 2. Monoclonal gammapathy was accompanied by polyclonal hypergammaglobulinaemia in 9 of 11 cases, hypogammaglobulinaemia - in 2. Conclusions. Quantitative and qualitative immunoglobulinopathies are observed in most patients at the onset of AITL. Quantitative abnormalities were determined more often than qualitative. Monoclonal gammapathy can be a manifestation of lymphoproliferation and other concomitant disorders. The prognostic value of immunochemical parameters is still unclear and requires dynamic observation and study.

About the authors

N G CHERNOVA

National Research Center for Hematology Russian Federation

Email: ngchernova@mail.ru
к.м.н., врач-гематолог отд-ния интенсивной высокодозной химиотерапии лимфом с круглосуточным и дневным стационаром, тел.: 8(495)612-48-10 (раб.), 8(916)660-27-63 (моб.); http://orcid.org/0000-0002-0827-4052 Moscow, Russia

N P SOBOLEVA

National Research Center for Hematology Russian Federation

врач централизованной клинико-диагностической лаборатории, http://orcid.org/0000-0002-1903-2446 Moscow, Russia

S A MARIINA

National Research Center for Hematology Russian Federation

врач централизованной клинико-диагностической лаборатории, http://orcid.org/0000-0002-9375-4076 Moscow, Russia

Y V SIDOROVA

National Research Center for Hematology Russian Federation

к.м.н., с.н.с., http://orcid.org/0000-0003-1936-0084 Moscow, Russia

M N SINITSYNA

National Research Center for Hematology Russian Federation

н.с., http://orcid.org/0000-0002-0750-8005 Moscow, Russia

V N DVIRNYK

National Research Center for Hematology Russian Federation

к.м.н., зав. централизованной клинико-диагностической лабораторией, http://orcid.org/0000-0002-9877-0796 Moscow, Russia

D S BADMAZHAPOVA

National Research Center for Hematology Russian Federation

аспирант, https://orcid.org/ 0000-0002-4223-2366 Moscow, Russia

Y E VINOGRADOVA

The State Education Institution of Higher Professional Training The First Sechenov Moscow State Medical University under Ministry of Health of the Russian Federation

к.м.н., доцент каф. госпитальной терапии №2, https://orcid.org/0000-0003-3353-1230 Moscow, Russia

E E ZVONKOV

National Research Center for Hematology Russian Federation

д.м.н., зав. отд-нием интенсивной высокодозной химиотерапии лимфом с круглосуточным и дневным стационаром, http://orcid.org/0000-0002-2639-7419 Moscow, Russia

V G SAVCHENKO

National Research Center for Hematology Russian Federation

акад. РАН, проф., генеральный директор, https://orcid.org/0000-0001-8188-5557 Moscow, Russia

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