Onkológia 3/2025
Secondary immunodeficiency in malignant lymphoproliferations
Immune response disorders result in a deficiency of the immune system. These defects represent a heterogeneous group of congenital, primary immunodeficiencies. In contrast, secondary immunodeficiencies (SIDs) constitute a broad group of acquired immune disorders with a decrease in the number and/or function of immune cells. The most common presentation of SIDs is a reduced level of antibodies occurring as a consequence of external influences, malignancy, autoimmunity or as an effect of drugs used to treat them. Typical examples of SIDs of the antibody type are hematological malignancies. In the era of immunomodulatory biologic agents used in their treatment, the distinction between SID and PID with antibody deficiency is important. SID in patients with B-cell hematological malignancies is a common condition that manifests itself with recurrent and severe infections. SID is caused by both immune defects caused by the malignancy and the therapy itself, which has B-cell damaging properties. Early diagnosis of SID and optimization of intervention strategies are key to providing the most effective cancer treatment and to reducing morbidity and mortality associated with infection. This review addresses recommendations and challenges for diagnosing SID in practice based on assessment of clinical status, history, and laboratory parameters of antibody immunity and the administration of immunoglobulin replacement therapy IgRT in reducing the frequency and severity of infections in patients with malignant lymphoproliferation.
Keywords: malignant lymphomas, secondary immunodeficiencies, immunoglobulins, vaccination, infections
