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Incidence of malignancy in patients with common variable immunodeficiency according to therapeutic delay: an Italian retrospective, monocentric cohort study

Authors
  • Pedini, Veronica1, 2
  • Verga, Jacopo Umberto3
  • Terrenato, Irene4
  • Menghini, Denise1
  • Mezzanotte, Cristina1
  • Danieli, Maria Giovanna1
  • 1 Polytechnic University of Marche, Ancona, Italy , Ancona (Italy)
  • 2 Destra Secchia Hospital, Pieve di Coriano, ASST Mantova, Mantua, Italy , Mantua (Italy)
  • 3 Molecular and Applied Biology, Polytechnic University of Marche, Ancona, Italy , Ancona (Italy)
  • 4 Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy , Rome (Italy)
Type
Published Article
Journal
Allergy, Asthma & Clinical Immunology
Publisher
BioMed Central
Publication Date
Jun 26, 2020
Volume
16
Issue
1
Identifiers
DOI: 10.1186/s13223-020-00451-z
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundCommon variable immunodeficiency (CVID) is the most common symptomatic primary immunodeficiency and has a broad spectrum of clinical manifestations. Among non-infectious complications, an increased incidence of malignancies may have a special relevance for survival, but little is known about treatment efficacy on malignant complications.MethodsThis was a monocenter retrospective study on CVID patients, designed to provide preliminary data for the investigation of the possible link between therapeutic delay and tumor incidence.ResultsA total of 67 CVID subjects were included. The median diagnostic delay was 7.5 years (range: 0–63 years), and the median therapeutic delay was 8.5 years (range: 0–67 years). Malignancies were diagnosed in 18 (27%) patients. Eight out of 18 (44%) patients with a malignancy had lymphoma. Patients who developed a malignancy showed a longer therapeutic delay in comparison to patients with no malignancy, although no statistical significance was achieved (11 years vs 8 years, respectively, p = 0.424). We observed a lower frequency of malignancy in CVID patients with reduced therapeutic delay compared with patients with therapeutic delay ≥ 10 years. With a therapeutic delay of > 1 year, 74% had no tumor, and 25% had a tumor; with a therapeutic delay of > 10 years, 65% had no tumor and 35% had a malignancy. Among patients who had no malignancy, 64% had a therapeutic delay of < 10 years, and 36% had a therapeutic delay of ≥ 10 years. Among patients with malignancy, 47% of subjects had a therapeutic delay < 10 years, and 53% a therapeutic delay ≥ 10 years.ConclusionsThe observation of clinical characteristics of our patients with CVID may suggest that an early institution of IgG replacement therapy could be of benefit for the prevention of malignant complications.Name of the registry: Comitato Etico Regionale delle Marche. Trial registration number: 1505. Date of registration: 27/10/2016, Retrospectively registered URL of trial registry record: http://www.ospedaliriuniti.marche.it/portale/archivio13_cerm-ancona_0_446_1.html. The trial was not registered before the first participant was enrolled

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