{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T05:43:32Z","timestamp":1758087812734,"version":"3.44.0"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,20]],"date-time":"2025-07-20T00:00:00Z","timestamp":1752969600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004844","name":"National Cheng Kung University Hospital","doi-asserted-by":"publisher","award":["NCKUH\u201011403015"],"award-info":[{"award-number":["NCKUH\u201011403015"]}],"id":[{"id":"10.13039\/501100004844","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Hypogammaglobulinaemia is a potential complication in children with acute lymphoblastic leukaemia (ALL) receiving chemotherapy. However, real\u2010world data on its prevalence and clinical impact remain limited. This study retrospectively reviewed 85 paediatric ALL patients completing Taiwan Pediatric Oncology Group (TPOG)\u2010ALL\u20102013 maintenance therapy to investigate secondary hypogammaglobulinaemia. At diagnosis, 6% (5\/85) of patients had hypogammaglobulinaemia, increasing to 49.2% (32\/65) during maintenance chemotherapy. Patients with very\u2010high\u2010risk disease, poor cytogenetics or baseline immunoglobulin G (IgG) &lt;1000\u2009mg\/dL were more likely to develop secondary hypogammaglobulinaemia. Febrile episodes were significantly more common in the hypogammaglobulinaemia group (40.6% had &gt;10 fever episodes) and were particularly frequent in patients with IgG &lt;400\u2009mg\/dL. However, hypogammaglobulinaemia was not associated with white blood cell count, measurable residual disease or long\u2010term survival outcomes. Although intravenous immunoglobulin (IVIG) replacement is well established in primary immunodeficiency and B\u2010cell malignancies, its role in paediatric ALL remains uncertain. Given the high prevalence of hypogammaglobulinaemia and its association with febrile episodes, routine IgG monitoring may help identify at\u2010risk patients. Further studies are needed to determine the clinical benefits of IVIG supplementation in this population.<\/jats:p>","DOI":"10.1111\/bjh.70027","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T06:28:56Z","timestamp":1753079336000},"page":"892-901","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of secondary hypogammaglobulinaemia in children with acute lymphoblastic leukaemia receiving maintenance chemotherapy"],"prefix":"10.1111","volume":"207","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3487-9511","authenticated-orcid":false,"given":"Chao\u2010Neng","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Pediatrics National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University  Tainan Taiwan"},{"name":"Department of Pediatrics College of Medicine, National Cheng Kung University  Tainan 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