Impact of immunoglobulin G2 subclass level on late-onset bacterial infection after allogeneic hematopoietic stem cell transplantation

Rie Yamazaki, Jun Kato, Yuya Koda, Masatoshi Sakurai, Keiichi Tozawa, Mikio Okayama, Hitomi Nakayama, Shintaro Watanuki, Taku Kikuchi, Naoki Hasegawa, Shinichiro Okamoto, Takehiko Mori

Research output: Contribution to journalArticle

Abstract

Background: Immunoglobulin (Ig) G2 subclass deficiency is known to be associated with recurrent bacterial respiratory infections caused by capsulated bacteria and is found mostly in pediatric patients. However, its impact after allogeneic hematopoietic stem cell transplantation (HSCT) has not been fully assessed. Methods: We retrospectively evaluated the relationship between IgG2 subclass levels and bacterial pneumonia in 74 adult patients who survived longer than 2 years after allogeneic HSCT. Results: During the evaluation period, nine patients developed bacterial pneumonia. The median IgG2 level was significantly lower in patients with an infectious episode than in those without (143 mg/dL vs 287 mg/dL; P < 0.01). In multivariate analysis, a history of rituximab therapy and cord blood as a stem cell source were significantly associated with decreased levels of both IgG2 and IgG2/IgG ratios (P < 0.05). Conclusions: Suboptimal serum IgG2 levels could increase susceptibility to late-onset bacterial pneumonia after allogeneic HSCT. IgG2 levels should be considered carefully, especially in patients receiving cord blood transplantation and/or rituximab treatment.

Original languageEnglish
Article numbere13086
JournalTransplant Infectious Disease
DOIs
Publication statusPublished - 2019 Jan 1

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Hematopoietic Stem Cell Transplantation
Bacterial Infections
Immunoglobulins
Immunoglobulin G
Bacterial Pneumonia
Fetal Blood
Respiratory Tract Infections
Stem Cells
Multivariate Analysis
Transplantation
Pediatrics
Bacteria
Therapeutics
Serum

Keywords

  • allogeneic hematopoietic stem cell transplantation
  • capsulated bacteria
  • immunoglobulin G2 deficiency
  • pneumonia
  • Streptococcus pneumoniae

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases

Cite this

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title = "Impact of immunoglobulin G2 subclass level on late-onset bacterial infection after allogeneic hematopoietic stem cell transplantation",
abstract = "Background: Immunoglobulin (Ig) G2 subclass deficiency is known to be associated with recurrent bacterial respiratory infections caused by capsulated bacteria and is found mostly in pediatric patients. However, its impact after allogeneic hematopoietic stem cell transplantation (HSCT) has not been fully assessed. Methods: We retrospectively evaluated the relationship between IgG2 subclass levels and bacterial pneumonia in 74 adult patients who survived longer than 2 years after allogeneic HSCT. Results: During the evaluation period, nine patients developed bacterial pneumonia. The median IgG2 level was significantly lower in patients with an infectious episode than in those without (143 mg/dL vs 287 mg/dL; P < 0.01). In multivariate analysis, a history of rituximab therapy and cord blood as a stem cell source were significantly associated with decreased levels of both IgG2 and IgG2/IgG ratios (P < 0.05). Conclusions: Suboptimal serum IgG2 levels could increase susceptibility to late-onset bacterial pneumonia after allogeneic HSCT. IgG2 levels should be considered carefully, especially in patients receiving cord blood transplantation and/or rituximab treatment.",
keywords = "allogeneic hematopoietic stem cell transplantation, capsulated bacteria, immunoglobulin G2 deficiency, pneumonia, Streptococcus pneumoniae",
author = "Rie Yamazaki and Jun Kato and Yuya Koda and Masatoshi Sakurai and Keiichi Tozawa and Mikio Okayama and Hitomi Nakayama and Shintaro Watanuki and Taku Kikuchi and Naoki Hasegawa and Shinichiro Okamoto and Takehiko Mori",
year = "2019",
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doi = "10.1111/tid.13086",
language = "English",
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T1 - Impact of immunoglobulin G2 subclass level on late-onset bacterial infection after allogeneic hematopoietic stem cell transplantation

AU - Yamazaki, Rie

AU - Kato, Jun

AU - Koda, Yuya

AU - Sakurai, Masatoshi

AU - Tozawa, Keiichi

AU - Okayama, Mikio

AU - Nakayama, Hitomi

AU - Watanuki, Shintaro

AU - Kikuchi, Taku

AU - Hasegawa, Naoki

AU - Okamoto, Shinichiro

AU - Mori, Takehiko

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Immunoglobulin (Ig) G2 subclass deficiency is known to be associated with recurrent bacterial respiratory infections caused by capsulated bacteria and is found mostly in pediatric patients. However, its impact after allogeneic hematopoietic stem cell transplantation (HSCT) has not been fully assessed. Methods: We retrospectively evaluated the relationship between IgG2 subclass levels and bacterial pneumonia in 74 adult patients who survived longer than 2 years after allogeneic HSCT. Results: During the evaluation period, nine patients developed bacterial pneumonia. The median IgG2 level was significantly lower in patients with an infectious episode than in those without (143 mg/dL vs 287 mg/dL; P < 0.01). In multivariate analysis, a history of rituximab therapy and cord blood as a stem cell source were significantly associated with decreased levels of both IgG2 and IgG2/IgG ratios (P < 0.05). Conclusions: Suboptimal serum IgG2 levels could increase susceptibility to late-onset bacterial pneumonia after allogeneic HSCT. IgG2 levels should be considered carefully, especially in patients receiving cord blood transplantation and/or rituximab treatment.

AB - Background: Immunoglobulin (Ig) G2 subclass deficiency is known to be associated with recurrent bacterial respiratory infections caused by capsulated bacteria and is found mostly in pediatric patients. However, its impact after allogeneic hematopoietic stem cell transplantation (HSCT) has not been fully assessed. Methods: We retrospectively evaluated the relationship between IgG2 subclass levels and bacterial pneumonia in 74 adult patients who survived longer than 2 years after allogeneic HSCT. Results: During the evaluation period, nine patients developed bacterial pneumonia. The median IgG2 level was significantly lower in patients with an infectious episode than in those without (143 mg/dL vs 287 mg/dL; P < 0.01). In multivariate analysis, a history of rituximab therapy and cord blood as a stem cell source were significantly associated with decreased levels of both IgG2 and IgG2/IgG ratios (P < 0.05). Conclusions: Suboptimal serum IgG2 levels could increase susceptibility to late-onset bacterial pneumonia after allogeneic HSCT. IgG2 levels should be considered carefully, especially in patients receiving cord blood transplantation and/or rituximab treatment.

KW - allogeneic hematopoietic stem cell transplantation

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KW - immunoglobulin G2 deficiency

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KW - Streptococcus pneumoniae

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