Correlation of Serum Immunoglobulins with Infection-Related Parameters During Induction Chemotherapy of Pediatric Acute Myeloid Leukemia: A Prospective Study

Abstract

Background: Immune dysfunction may be a contributing factor for infections during induction chemotherapy of pediatric acute myeloid leukemia (AML); but this has not been evaluated as yet. Procedure: From April 2010 to May 2011, 45 consecutive de novo pediatric AML patients were prospectively evaluated along with nine healthy controls. Immunoglobulins (Ig) (n = 45) were measured at diagnosis and day 15. Results: There were 25 male and 20 female patients with a median age of 9 years (range 1–18 years). Baseline Ig did not correlate with any of the infection-related parameters during induction. At day 15, Ig levels reduced from baseline (IgG p = 0.46, IgA p = 0.027, IgM p < 0.001). Day 15 IgG levels were lower in patients with persistent fever >7 days (p = 0.029) and fungal infection (p = 0.035). Conclusion: This is the first study which has evaluated derangement in Ig with infection-related parameters in pediatric AML. At day 15, immunoglobulins decrease and reduced IgG levels correlate with infection-related parameters. Use of intravenous immunoglobulins in pediatric AML cases needs to be further evaluated to assess whether it can reduce infection-related morbidity.

Keywords:

• Immunoglobulin
• induction chemotherapy
• infection
• pediatric acute myeloid leukemia