Ask the RN Question:
My next visit with the oncologist is on 10/13 (every three months) and I’m extremely concerned about Immunoglobulin issues. Regarding immunity issues, my IgA (17 mg/dl) and IgG (383 mg/dl) are significantly below the normal ranges, and both are consistently trending downward. IgMis at the lowest end of the normal range (15 mg/dl) and is also consistently trending downward. I know IgA and IgM issues are untreatable, but do the IgG results portend the need for IGIV/SCIG?
Answer: It is a relatively common finding to have antibody deficiency in CLL. The incidence seems to increase with disease duration and is present in up to 85% of patients at some point in the course of their disease. Published guidelines suggest that patients with a history of recurrent bacterial infections combined with a documented failure of antibody production are the ones who should be treated with antibiotic prophylaxis. Then replacement immunoglobulins should be used only for those who suffer with significant and repetitive bacterial infections.
Since you mentioned not having recurrent infections, it sounds like there probably is no action needed at this point in time. Remain diligent with infection control measures as much as you can, and should you begin to have recurrent infections-definitely discuss treatment with your healthcare provider.
