Sinem ÖZTEKİN, Ünal ATAŞ, Utku ILTAR, Orhan Kemal YÜCEL, Ozan SALİM, Levent ÜNDAR
Journal of Current Hematology & Oncology Research - 2026;4(3):93-98
Aims : To evaluate the prognostic value of hypogammaglobulinemia at diagnosis in patients with diffuse large B-cell lymphoma (DLBCL) and its association with clinical characteristics and survival outcomes. Methods : A total of 177 adult patients with newly diagnosed DLBCL and available serum immunoglobulin G (IgG) levels were retrospectively analyzed. IgG-defined hypogammaglobulinemia was defined as IgG <700 mg/dl at diagnosis. Results : IgG-defined hypogammaglobulinemia was identified in 27 patients (15.3%). There were no significant differences between patients with and without IgG-defined hypogammaglobulinemia in terms of age and gender distribution. However, IgG-defined hypogammaglobulinemia was associated with more frequent B symptoms, extranodal involvement, elevated lactate dehydrogenase levels, poor Revised International Prognostic Index (R-IPI) scores, lower serum albumin levels, and a higher rate of infections during follow-up. The median follow-up time was 33 months (range, 0,1-166 months). Patients with IgG-defined hypogammaglobulinemia had significantly shorter progression-free survival (PFS) (p=0.044) and overall survival (OS) (p=0.001). In univariable analysis, IgG-defined hypogammaglobulinemia, ECOG performance status >1, poor R-IPI score, low albumin levels, presence of B symptoms, bone marrow involvement, and infection during follow-up were associated with inferior survival outcomes. In multivariable analysis, IgG-defined hypogammaglobulinemia was not an independent prognostic factor for PFS but remained independently associated with OS in the model including R-IPI. Conclusion : IgG-defined hypogammaglobulinemia at diagnosis may be associated with inferior survival outcomes in patients with DLBCL. Further prospective multicenter studies are needed to clarify its independent prognostic significance and potential role in risk stratification.
