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Complex Evaluation of Immune Defects in Patients with Chronic Lymphocytic Leukemia
Vodárek, Pavel ; Belada, David (advisor) ; Doubek, Michael (referee) ; Papajík, Tomáš (referee)
Complex evaluation of immune defects in patients with chronic lymphocytic leukemia MUDr. Pavel Vodárek Abstract of dissertation thesis Chronic lymphocytic leukemia (CLL) is associated with significant combined immunodeficiency. Amongst most important immune defects are hypogammaglobulinemia and changes in relative and absolute counts of different lymphocyte populations and subsets. As consequence of these changes, there can be higher frequency of infections and progression of CLL itself. The impact of chemoimmunotherapy (CIT) on immunoglobulin (Ig) levels and lymphocyte populations has not been extensively studied. In this dissertation thesis, we analysed Ig levels and lymphocyte populations (using flow cytometry) in 45 patients with indolent untreated CLL and 90 patients with progressive disease indicated for treatment. In 58 patients, we evaluated the impact of first-line CIT. For lymphocyte populations' analysis, we had also cohort of 34 healthy controls. Patients with progressive disease had significantly lower levels of all Ig classes and subclasses than patients with inactive disease: IgG, median 6.96 vs. 9.86 g/l, p=0.0001; IgA, median 0.63 vs. 1.53 g/l, p<0.0001; IgM, median 0.36 vs. 0.57 g/l, p=0.0035. After treatment, median IgA increased from 0.59 g/l to 0.74 g/l (p=0.0031). Other Ig classes and...
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