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Reduction of respiratory infections in a patient with profound hypogammaglobulinemia and B-cell chronic lymphocytic leukemia, treated with dialyzable leukocyte extract.

Erika Coria-Ramirez*, Maria del Carmen Sanchez-Leon, Maria C. Jimenez Martinez

B-cell chronic lymphocytic leukemia (B-CLL) is the most frequent leukemia in adults in western countries, it is associated with immune dysfunction at many levels, but humoral immunodeficiency is the most relevant clinical trait. Hypogammaglobulinemia can be present at the diagnosis, but it would worsen due to chemotherapy. Immunoglobulin levels are variable, putting patients at risk of multiple infections. Treatment of hypogammaglobulinemia consists of antimicrobial prophylaxis, vaccines, and human immunoglobulin G replacement. We present the case report of a 67 years-old male patient with B-CLL who received three cycles of fludarabine, cyclophosphamide, and dexamethasone, achieving disease control but developed hypogammaglobulinemia, causing him recurrent upper respiratory tract infections. We initiated treatment with Dialyzable leukocyte extract, an immunomodulator derived from human leukocytes, which has been used for several decades in different immunological diseases. After 24 months of treatment, the patient´s respiratory infections decreased Conclusion: Dialyzable leukocyte extract can be effective in controlling recurrent infections in patients with CLL-associated hypogammaglobulinemia