Canadian CLL Meeting 2015 Anti-Malarial Drugs Disrupt Lysosomes in Chronic Lymphocytic Leukemia (CLL) Cells

CLL is the most common type of leukemia in the Western world and represents the most common cause of secondary immunodeficiency which can benefit from immunoglobulin replacement therapy (IgRT). While immunoglobulin replacement therapy is usually administered intravenously in a hospital or outpatient facility, the availability of subcutaneous (SCIg) administration is often very appreciated by patients, for it offers greater flexibility and can lead to improved independence and quality of life. We conducted a pilot study to assess the feasibility of subcutaneous immunoglobulin replacement (SCIG) in patients with secondary hypogammaglobulinemia due to B lymphocytederived malignancies. Five patients were transitioned from intravenous replacement (IVIG) to SCIG. Mean patients’ serum levels of IgG on IVIg were 7.32 g/L while they increased to 11.39 g/L on SCIg. For IVIg, infections occurred almost once a month on average, while they were almost reduced to none after the SCIg switch. Moreover, no adverse effects were manifest after the SCIg change, as opposed to some serious discomfort in the case of 2 patients under the IVIg regime. This, in turn, contributed to an important reduction in the number of hospital visits related to the treatment. This pilot trial suggests that SCIG may represent a feasible alternative to IVIG for the management of patients with secondary hypogammagloublinemia A Canadian Perspective on the Use of Immunoglobulin Therapy to Reduce Infectious Complications in Chronic Lymphocytic Leukemia S. Lachance MD,* A. Christofides MSc,† J. Lee MD,‡ L. Sehn MD,§ B. Ritchie MD,|| C. Shustik MD,# D. Stewart MD,** C. Toze MD,§ E. Haddad MD,†† D. C. Vinh MD#, Ayman