{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:00:40Z","timestamp":1789545640485,"version":"build-2803163510"},"reference-count":88,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T00:00:00Z","timestamp":1701993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Malignancies of the B\u2010lymphocyte lineage are among the most diagnosed haematological malignancies in clinical practice. In our community, multiple myeloma (MM) and its precursor condition monoclonal gammopathy of undetermined significance are the commonest, accounting for ~12% of diagnoses, followed by chronic lymphocytic leukaemia (CLL) and its precursor condition monoclonal B lymphocytosis, ~9%. Along with diffuse large B cell lymphoma, follicular lymphoma and marginal zone lymphoma, these conditions comprise around a third of all haematological malignancies diagnosed. Infection remains an important cause of mortality and morbidity in the management of patients with these conditions. This is in part treatment\u2010related but also reflective of disease\u2010related immune dysfunction. Infectious complications account for up to 50% of early mortality in patients with myeloma and up to 50% of all mortality in patients with CLL. A variety of strategies are available to decrease the morbidity and mortality of infectious complications; however, practices vary between countries and often between treating physicians. Treatment options have evolved significantly over the last decade, with the introduction of monoclonal antibodies, small molecule inhibitors, second\u2010 and third\u2010generation immunomodulatory agents and CAR\u2010T cell therapy. Much of the data that inform clinical practice in infection management predates current therapeutic approaches. This is in part because of the rapid development of new therapies but also reflective of the long natural history of many of these diseases and the need for prolonged periods of observation. In this article, we review the aspects of disease and treatment that contribute to immune dysfunction in MM, CLL and B\u2010cell non\u2010Hodgkin lymphoma and review the current strategies used to manage immune dysfunction and infection.<\/jats:p>","DOI":"10.1111\/imj.16279","type":"journal-article","created":{"date-parts":[[2023,12,9]],"date-time":"2023-12-09T05:24:20Z","timestamp":1702099460000},"page":"16-25","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pathogenesis and management of immune dysfunction secondary to B cell haematological malignancies"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3785-2931","authenticated-orcid":false,"given":"Kyle","family":"Crassini","sequence":"first","affiliation":[{"name":"MNCCI, Coffs Harbour Health Campus  Coffs Harbour New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Haematology Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,8]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Australian Institute of Health and Welfare.Cancer Data in Australia; 2023."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.240762"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2152-2650(21)01240-4"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020006540"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2016.08.003"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0188988"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.20.6.1625"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/bcj.2015.32"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-02-554071"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.03.2086"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2014.107714"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.1998.tb01075.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.18632\/aging.101284"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1086\/605664"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2009.236"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mce.2010.04.005"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2009.255"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2012.067272"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-12-687749"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0211927"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/cts.12532"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1505654"},{"key":"e_1_2_6_24_1","unstructured":"eviQ Infection During Cancer Treatment."},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1586\/14787210.2015.1083858"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.3816\/CLM.2009.n.036"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13374"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2014.114025"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13223"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90180-5"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1995.tb08447.x"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428190902856824"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-011-1275-3"},{"key":"e_1_2_6_34_1","article-title":"Effect of immunoglobulin therapy on the rate of infections in multiple myeloma patients undergoing autologous stem cell transplantation or treated with immunomodulatory agents","volume":"2","author":"Khalafallah A","year":"2010","journal-title":"Mediterr J Hematol Infect Dis"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12424"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2017.11.014"},{"key":"e_1_2_6_37_1","unstructured":"European Medicines Agency.Guideline on the Clinical Investigation of Human Normal Immunoglobulin for Intravenous Administration (IVIg); 2010. Available from URL:https:\/\/www.ema.europa.eu\/en\/documents\/scientific-guideline\/guideline-clinical-investigation-human-normal-immunoglobulin-intravenous-administration-ivig_en.pdf"},{"key":"e_1_2_6_38_1","unstructured":"National Blood Authority.Criteria for the Clinical Use of Immunoglobulin in Australia. Available from URL:https:\/\/www.criteria.blood.gov.au."},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2016.09.023"},{"key":"e_1_2_6_40_1","unstructured":"ProvanD Nokes JC Agrawal S Winer J Wood P.Clinical Guidelines for Immunoglobulin Use; 2012. Available from URL:https:\/\/igd.mdsas.com\/wp-content\/uploads\/2016\/04\/Clinical-Guidelines-SECOND-EDITION.pdf"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-022-01680-z"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2014.00257"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(21)00278-7"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21051825"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-03-567388"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.3816\/CLM.2009.n.071"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1038\/bcj.2016.105"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15146"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.02.003"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.152272"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12402"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1815281"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1513257"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30012-8"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-04-639203"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2018.03.004"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15516"},{"key":"e_1_2_6_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2018.04.007"},{"key":"e_1_2_6_59_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1400376"},{"key":"e_1_2_6_60_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.12.516"},{"key":"e_1_2_6_61_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.12595"},{"key":"e_1_2_6_62_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.12599"},{"key":"e_1_2_6_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2020.103203"},{"key":"e_1_2_6_64_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198810063191403"},{"key":"e_1_2_6_65_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2016.00317"},{"key":"e_1_2_6_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2017.09.003"},{"key":"e_1_2_6_67_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18014"},{"key":"e_1_2_6_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2015.10.001"},{"key":"e_1_2_6_69_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12979-018-0130-y"},{"key":"e_1_2_6_70_1","doi-asserted-by":"publisher","DOI":"10.12968\/hmed.2010.71.5.47906"},{"key":"e_1_2_6_71_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-06-1070"},{"key":"e_1_2_6_72_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature07205"},{"key":"e_1_2_6_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)70027-0"},{"key":"e_1_2_6_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2015.10.012"},{"key":"e_1_2_6_75_1","doi-asserted-by":"publisher","DOI":"10.1159\/000449251"},{"key":"e_1_2_6_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2012.11.011"},{"key":"e_1_2_6_77_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2015.10.013"},{"key":"e_1_2_6_78_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428190902730219"},{"key":"e_1_2_6_79_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2009.07715.x"},{"key":"e_1_2_6_80_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2010.03.025"},{"key":"e_1_2_6_81_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-020-04567-7"},{"key":"e_1_2_6_82_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11899-017-0382-1"},{"key":"e_1_2_6_83_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.10.039"},{"key":"e_1_2_6_84_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa044097"},{"key":"e_1_2_6_85_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050078"},{"key":"e_1_2_6_86_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1004095"},{"key":"e_1_2_6_87_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-04-494096"},{"key":"e_1_2_6_88_1","doi-asserted-by":"publisher","DOI":"10.4084\/mjhid.2016.044"},{"key":"e_1_2_6_89_1","unstructured":"Zoe McQuilten R.W. PhilipCrispin AmberDegelia ClaireDendle MichaelGilbertson AnnaJohnston AnastaziaKeegan DominicPepperell HumphreyPullon JohnReynolds TinavanTonder JudithTrotman NeilWaters CameronWellard HelenWeston C. OrlaMorrissey EricaWood.Rational: a randomised controlled feasibility trial comparing prophylactic immunoglobulin with antibiotics in patients with acquired hypogammaglobulinemia secondary to haematological malignancies; 2021."}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.16279","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T03:16:08Z","timestamp":1706152568000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.16279"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,8]]},"references-count":88,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1111\/imj.16279"],"URL":"https:\/\/doi.org\/10.1111\/imj.16279","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,8]]},"assertion":[{"value":"2023-02-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}