# Understanding secondary hypogammaglobulinemia and its implications for cancer prognosis in children: A retrospective cohort study

## TL;DR

This study explores how low immunoglobulin levels in children with cancer may affect their prognosis, emphasizing the need for early detection.

## Contribution

The study identifies hypogammaglobulinemia as a potential marker for poor cancer outcomes in children.

## Key findings

- Most significant reduction in IgA levels was observed during treatment and linked to infections and death.
- Initial immunoglobulin levels at diagnosis were normal in all patients.
- Hypogammaglobulinemia during follow-up was associated with poorer prognosis.

## Abstract

Immunodeficiencies are disturbances in the immune system that can affect cell function, quantity, or both. They can be either primary, associated with genetic defects, or secondary, linked to external factors such as hemato-oncological conditions. Secondary immunodeficiencies can lead to the initiation, reactivation, or acceleration of latent, residual, or active infections, which are the leading cause of mortality.

To elucidate the occurrence and clinical characteristics of hypogammaglobulinemia in pediatric oncology patients in a high-complexity hospital in Colombia between January 2020 and December 2022.

We conducted an observational study with patients under 18 years old with a cancer diagnosis, serum immunoglobulins measurements at the time of the diagnosis, and later follow-up during treatment.

We included 133 patients with a median age of eight years. Based on local guidelines of immunoglobulin levels for age, all patients had normal values at the time of cancer diagnosis. In the follow-up, the most significant reduction among all ages was for IgA and was related to infections and death.

Our findings highlight the importance of measuring immunoglobulin levels at the time of the cancer diagnosis, as hypogammaglobulinemia may be linked to a poorer prognosis. Early detection could potentially improve patient outcomes.