Serum Immunoglobulin Levels in Children with Acute Lymphoblastic Leukemia During Maintenance Chemotherapy and its Association with Severe Febrile Illness.

IF 1.7 4区医学 Q2 PEDIATRICS

Indian pediatrics Pub Date : 2025-07-01 Epub Date: 2025-04-15 DOI:10.1007/s13312-025-00034-4

Maharshi Trivedi, Priyakumari Thankamony, Manjusha Nair, Binitha Rajeswari, Guruprasad Chellappan Sojamani, Shwetha Seetharam, Prasanth Varikkattu Rajendran, Jagathnath Krishna

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引用次数: 0

Abstract

Objective: To determine the proportion of children with acute lymphoblastic leukemia (ALL) with hypoglobulinemia during maintenance chemotherapy and to determine its association with severe febrile illnesses.

Methods: Children with ALL receiving maintenance chemotherapy were prospectively recruited and serum immunoglobulin levels (IgG, IgM, IgA) were measured by turbidimetric method. Children were followed up for severe febrile illnesses for 6 months or till the completion of treatment.

Results: We enrolled 199 children with mean (SD) age 82.03 (39.34) months; 58, 52, 47, and 42 children had received 0-6, 7-12, 13-18 and 19-24 months of maintenance chemotherapy, respectively. Hypo-IgG, hypo-IgA, and hypo-IgM were seen in 56.8%, 80.4%, and 86.4% of children. 91 (45.7%) children developed 147 episodes of severe febrile illness. Older age (> 5 years) was associated with decreased risk [odds ratio 95% CI] of hypo-IgG [0.540 (0.297, 0.982), P = 0.044], hypo-IgA [0.030 (0.011, 0.088), P = 0.001], and hypo-IgM [0.323 (0.117, 0.894), P = 0.030] and female gender had decreased risk of hypo-IgG (0.539 (0.305, 0.953), P = 0.033). Older age decreased the risk [0.585 (0.328, 1.041), P = 0.014] and girls were at increased risk [(1.118, 3.488), P = 0.019] of severe febrile illness. Hypoglobulinemia did not increase the risk of severe febrile illness.

Conclusion: Hypoglobulinemia was not found to be an independent risk factor for severe febrile illnesses in children with ALL receiving maintenance chemotherapy.

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急性淋巴细胞白血病患儿维持化疗期间血清免疫球蛋白水平及其与重症温病的关系

目的：了解急性淋巴细胞白血病（ALL）患儿在维持化疗期间伴低球蛋白血症的比例及其与重症发热性疾病的关系。方法：前瞻性招募接受维持化疗的ALL患儿，采用比浊法检测血清免疫球蛋白（IgG、IgM、IgA）水平。对重症发热性疾病患儿随访6个月或至治疗结束。结果：199名儿童入组，平均（SD）年龄82.03（39.34）个月；分别有58例、52例、47例和42例患儿接受0-6、7-12、13-18和19-24个月的维持化疗。低igg、低iga和低igm分别见于56.8%、80.4%和86.4%的儿童。91例（45.7%）儿童出现147次严重发热性疾病。年龄越大（0 ~ 5岁）与低igg [0.540 (0.297, 0.982), P = 0.044]、低iga [0.030 (0.011, 0.088), P = 0.001]、低igm [0.323 (0.117, 0.894), P = 0.030]、低igg [0.539 (0.305, 0.953), P = 0.033]的风险降低相关。年龄越大，发生高热性疾病的风险降低[0.585 (0.328,1.041),P = 0.014]，女孩发生高热性疾病的风险增加[(1.118,3.488),P = 0.019]。低球蛋白血症不会增加严重发热性疾病的风险。结论：低球蛋白血症并不是接受维持性化疗的ALL患儿发生严重发热性疾病的独立危险因素。

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来源期刊

Indian pediatrics 医学-小儿科

CiteScore

3.30

自引率

8.70%

发文量

344

审稿时长

3-8 weeks

期刊介绍： The general objective of Indian Pediatrics is "To promote the science and practice of Pediatrics." An important guiding principle has been the simultaneous need to inform, educate and entertain the target audience. The specific key objectives are: -To publish original, relevant, well researched peer reviewed articles on issues related to child health. -To provide continuing education to support informed clinical decisions and research. -To foster responsible and balanced debate on controversial issues that affect child health, including non-clinical areas such as medical education, ethics, law, environment and economics. -To achieve the highest level of ethical medical journalism and to produce a publication that is timely, credible and enjoyable to read.