Association of mannose-binding lectin levels and invasive fungal disease in hematologic malignancy patients receiving myelosuppressive chemotherapy or allogeneic hematopoietic stem cell transplantation

Abstract

Several studies have suggested an association of mannose-binding lectin (MBL) deficiency with infections. In this study, we investigated the association between MBL deficiency and invasive fungal disease (IFD) in hematologic malignancy patients receiving myelosuppressive chemotherapy or hematopoietic stem cell transplant. MBL levels were quantified at the start of treatment in 152 patients who were followed for 6 months and scored as developing IFD or not. Forty-five patients (29.6%) developed IFD, of which 21 (46.7% of IFD cases and 13.8% of patients) were proven or probable IFD. Fifty-nine (38.8%) had MBL levels <1000 ng/mL. The rates of all IFD in patients with MBL levels below and above 1000 ng/mL were 33.9% and 26.9%, respectively (P=0.356). The rates of proven or probable IFD in patients with MBL levels below and above 1000 ng/mL were 11.9% and 15.1%, respectively (P=0.579). MBL levels <1000 ng/mL were not predictors of death (P=0.233). As expected, IFD was associated with death (P<0.0001). Our findings indicate that MBL levels <1000 ng/mL were not associated with an increased risk of developing IFD or overall survival.

Low pre-transplant levels of mannose-binding lectin are associated with viral infections and mortality after haematopoietic allogeneic stem cell transplantation

“…In the present study, the cause of death in all patients was infection, predominantly viral and Aspergillus infection. Recent report shows association of fungal invasive disease with death in patients with haematologic malignancy [13]. We did not find a relation between the recipient or donor MBL 2 genotype and mortality.…”

“…Likewise, there are conflicting results or contradictory data about whether MBL2 genotypes or MBL deficiency could be used as mortality predictors in HSCT patients [13, 16, 17, 30, 31]. In the present study, the cause of death in all patients was infection, predominantly viral and Aspergillus infection.…”

“…In patients with haematological malignancies receiving chemotherapy, increased susceptibility to infection and prolonged duration of febrile neutropenic episodes have been associated with MBL deficiency [8–10]. However, these observations were not consistent in all study cohorts [11–13]. In autologous HSCT [14–17] showed conflicting results regarding the influence of MBL2 genotype and functional MBL deficiency on infection risk.…”

“…In addition, it is difficult to compare these different studies, because of some studies focused on MBL levels while others determined MBL2 genotype, and even more because of different MBL cut-off levels and different MBL2 genotype or haplotype combinations that are considered deficient [14–25]. Furthermore, over the years, research on MBL in Allo-HSCT has addressed the question of whether or not MBL is associated with their prognosis without reaching clear conclusions [13].…”

Effects of immunoadsorption combined with membrane filtration on complement markers – results of a randomized, controlled, crossover study

“…Reference values: 30-3000 lg/l. However, Riwes et al [24] recently reported that, in the setting of hematologic malignancy, patients that received myelosuppressive chemotherapy or allogeneic hematopoietic stem-cell transplantation had MBL levels that were <1000 ng/ml, and this was not associated with an increased risk of developing invasive fungal disease and had no impact upon overall survival. As observed for properdin, recovery of MBL levels took significantly longer after IA alone compared to IA + MF.…”