{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:09:15Z","timestamp":1762430955716},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,1,26]],"date-time":"2015-01-26T00:00:00Z","timestamp":1422230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Hypogammaglobulinemia (hypo\u2010IgG) is common early post\u2010HSCT in children, occasionally necessitating long\u2010term immunoglobulin (Ig) G replacement therapy. IgG replacement may not reduce mortality, although infectious complications are decreased<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Clinical data and samples from 86 children were analyzed retrospectively with the aim to identify risk factors for developing long\u2010term hypo\u2010IgG (i.e., requiring \u22653 months IgG replacement) post\u2010HSCT and studying the underlying biology. Laboratory studies covered serum cytokines, <jats:italic>IGHG2<\/jats:italic> genotyping and routine laboratory investigations. Results were analyzed statistically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010eight percent of the children developed long\u2010term hypo\u2010IgG. These children were younger (&lt;5 years) and had higher acute GvHD incidence, but had better overall survival (88% vs. 69%, <jats:italic>P<\/jats:italic>\u2009=\u20090.036). Significantly lower Ig levels post\u2010HSCT but equal immune cell recovery were seen in patients with long\u2010term hypo\u2010IgG compared with those of transient or no hypo\u2010IgG. Pre\u2010HSCT IL\u20106 and \u20107 and post\u2010HSCT BAFF and APRIL levels were significantly higher in the long\u2010term hypo\u2010IgG group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Findings suggests an unfavorable cytokine milieu for graft\u2010derived immune recovery, possibly inducing Ig isotype class switch arrest. Younger age, acute GvHD, and higher pre\u2010HSCT IL\u20106 levels were identified as significant risk factors for long\u2010term hypo\u2010IgG. Long\u2010term hypo\u2010IgG post\u2010HSCT does not need to be unfavorable and could be an effect of deteriorated cytokine signaling. Pediatr Blood Cancer 2015;62:890\u2013896. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.25409","type":"journal-article","created":{"date-parts":[[2015,1,26]],"date-time":"2015-01-26T20:11:15Z","timestamp":1422303075000},"page":"890-896","source":"Crossref","is-referenced-by-count":8,"title":["Hypogammaglobulinemia in children after allogeneic hematopoietic stem cell transplantation: A cytokine mediated immunoglobulin isotype class switch arrest?"],"prefix":"10.1002","volume":"62","author":[{"given":"Mikael","family":"Sundin","sequence":"first","affiliation":[{"name":"Division of Pediatrics, Department of Clinical Science Intervention and Technology (CLINTEC); and"},{"name":"Department of Oncology\u2010Pathology Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mats","family":"Remberger","sequence":"additional","affiliation":[{"name":"Hematology\/Immunology\/HSCT Section, Astrid Lindgren Children's Hospital"},{"name":"Center for Allogeneic Stem Cell Transplantation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henric","family":"Lindqvist","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, Department of Clinical Science Intervention and Technology (CLINTEC); and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigitta","family":"Omazic","sequence":"additional","affiliation":[{"name":"Hematology\/Immunology\/HSCT Section, Astrid Lindgren Children's Hospital"},{"name":"Department of Clinical Immunology and Transfusion Medicine Karolinska University Laboratory; Karolinska University Hospital Huddinge Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berit","family":"Sundberg","sequence":"additional","affiliation":[{"name":"Hematology\/Immunology\/HSCT Section, Astrid Lindgren Children's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Uzunel","sequence":"additional","affiliation":[{"name":"Hematology\/Immunology\/HSCT Section, Astrid Lindgren Children's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacek","family":"Winiarski","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, Department of Clinical Science Intervention and Technology (CLINTEC); 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