Hypogammaglobulinaemia present

[Abc123qaz]

On Venetoclax’till 8/22. No paraprotein seen in recent blood test.

Leukocytes 3.3; MCH 32.7; neutrophils 1.97; lymphocytes 0.59; eosinophils 0.00

Rest of samples are within normal range.

I’ve had 3 shots of Pfizer, last one 5/11/21.

Worried about the above hypo…comment on IgG 4.79; IgM 0.05; IgA 0.63.

Do I need tx for this???

Side effects from Passed treatment for me is small nerve damage in feet and lower legs but still enjoying a daily walk. Fatigue is a problem last few months but feel well when in the fresh air.

Can anyone advise me please.

Eileen

[AussieNeil Administrator]

Unless your IgG falls below 4. 0 (may be different where you live) and you are having frequent, serious infections, you won't qualify for IgG infusions.

Update: Did your hypogammaglobulinemia develop during treatment or was it present beforehand?

Neil

[Abc123qaz in reply to AussieNeil]

Thank you Neil, yes , my IgG have been reducing slowly since the start of Venetoclax , but I’m MRD negative and lymph nodes normal. Maybe my immune system will improve when Ven tx is complete. I feel reassured since your reply. Regards, Eileen

[bennevisplace]

I don't know the protocol for treating hypogammaglobulinaemia in Ireland. In England I think it's as AussieNeil says, but it's a discussion I've never had with my haematologist.

I know that treatment lowers Ig levels, it's par for the course. Hgg has been on my notes ever since, and 19 months after finishing treatment with FCR my IgG level was still 2.7 g/L, which by the book means "severe". Neutrophils were less than 1 for over a year, minimum 0.1. But the infections I had, mainly viral, never came to anything and possible treatment with IVIG was never mentioned. Maybe the habits brought on by Covid - handwashing, shielding etc - reduced my exposure at a critical time, but I'm not the only member here with this experience. Some folk get serious infections, some don't, and Ig levels don't tell the whole story. I hope you will not need treatment for your hgg.

[Abc123qaz in reply to bennevisplace]

Thank you Ben…, I’m the same as you, no infections since the beginning of Covid!! One of the side effects of Venetoclax is, as far as I know, a lower immune system. Feel relief since Neil’s explanation. Regards, Eileen