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The overall survival of patients with chronic lymphocytic leukemia (CLL) has improved significantly over the years; however, the clinical course remains highly heterogeneous, and infections continue to be a major cause of death.
Given the high risk of infection in patients with CLL, infection prophylaxis has to play a key role. Presently, immunoglobulin replacement therapy (IgRT) is recommended to patients with low IgG levels who have already experienced at least two severe infections within a year. Recent clinical developments bring novel perspectives to this approach.
During this session, the results of a real-world retrospective study analyzing the infection risk in CLL patients based on their history of infections and treatments were discussed. Emphasis was placed on how infections of varying degrees of severity are modulated after initiation of IgRT. Subsequently, a second study based on a sample analysis representative of the practice in Germany was presented. It details the risk factors for infections in CLL patients and highlights the impact of the adherence to IgG substitution guidelines on infectious episodes. Then, real-world data on the use of subcutaneous immunoglobulin therapy in CLL patients suffering from antibody deficiency were presented and therapies under development were reviewed.
In the last part of the session, the live audience and faculty had the opportunity to exchange views and debated on challenging cases of CLL-associated infections. Questions from the audience were answered at the end of the session.
Caspar da Cunha-Bang is a senior registrar in hematology and group leader of the Clinical Research Unit of the department at Rigshospitalet, Denmark. He holds an MD and PhD with a specific focus on infectious complications in immunocompromised hosts.
His research is specialized in clinical trials targeting chronic lymphocytic leukemia. He is a member of national and international study groups in this field, and author of numerous publications in high impact journals.
Hartmut Link is Professor of Medicine, Consultant in Hematology and Medical Oncology, and former Head of the Department of Hematology and Oncology at the Westpfalz Hospital in Kaiserslautern, Germany. He also runs a company specialized in digitized oncology therapy regimens.
His research interests cover stem cell transplantation, infections in immunosuppressed patients, and phase II-IV clinical trials in oncology. He is a member of guideline commissions of the German Cancer Society.
Livio Trentin is full professor of Hematology at the University of Padua and Head of the Hematology Section at the Azienda Ospedale Università Padova.
His research activities center on investigations of mechanisms driving leukemic cell proliferation and survival in B-cell chronic malignancies. His interest also includes tumor immunology and related secondary immunodeficiencies. He has authored more than 300 publications in the field of lymphocyte malignancies.