Immunomodulatory effects of different intravenous immunoglobulin preparations in chronic lymphocytic leukemia

Ana Colado, Esteban Enrique Elías, Valeria Judith Sarapura Martínez, Gregorio Cordini, Pablo Morande, Fernando Bezares, Mirta Giordano, Romina Gamberale, Mercedes Borge*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)


Hypogammaglobulinemia is the most frequently observed immune defect in chronic lymphocytic leukemia (CLL). Although CLL patients usually have low serum levels of all isotypes (IgG, IgM and IgA), standard immunoglobulin (Ig) preparations for replacement therapy administrated to these patients contain more than 95% of IgG. Pentaglobin is an Ig preparation of intravenous application (IVIg) enriched with IgM and IgA (IVIgGMA), with the potential benefit to restore the Ig levels of all isotypes. Because IVIg preparations at high doses have well-documented anti-inflammatory and immunomodulatory effects, we aimed to evaluate the capacity of Pentaglobin and a standard IVIg preparation to affect leukemic and T cells from CLL patients. In contrast to standard IVIg, we found that IVIgGMA did not modify T cell activation and had a lower inhibitory effect on T cell proliferation. Regarding the activation of leukemic B cells through BCR, it was similarly reduced by both IVIgGMA and IVIgG. None of these IVIg preparations modified spontaneous apoptosis of T or leukemic B cells. However, the addition of IVIgGMA on in vitro cultures decreased the apoptosis of T cells induced by the BCL-2 inhibitor, venetoclax. Importantly, IVIgGMA did not impair venetoclax-induced apoptosis of leukemic B cells. Overall, our results add new data on the effects of different preparations of IVIg in CLL, and show that the IgM/IgA enriched preparation not only affects relevant mechanisms involved in CLL pathogenesis but also has a particular profile of immunomodulatory effects on T cells that deserves further investigation.

Original languageEnglish
Article number12926
Pages (from-to)12926
JournalScientific Reports
Issue number1
Publication statusPublished - 21 Jun 2021


  • Apoptosis/drug effects
  • B-Lymphocytes/immunology
  • Bridged Bicyclo Compounds, Heterocyclic/pharmacology
  • Humans
  • Immunoglobulin A/immunology
  • Immunoglobulin G/immunology
  • Immunoglobulin M/immunology
  • Immunoglobulins, Intravenous/immunology
  • Immunomodulation/drug effects
  • Leukemia, Lymphocytic, Chronic, B-Cell/blood
  • Lymphocyte Activation/immunology
  • Lymphocytes/immunology
  • Receptors, Antigen, T-Cell/metabolism
  • Sulfonamides/pharmacology


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