Effects of Various Immunoglobulin Products on Serum (1‐3)‐β‐D‐glucan Levels

ABSTRACT Background (1‐3)‐β‐D‐glucan (β‐D‐glucan), a component of fungal cell walls and an important diagnostic biomarker of invasive fungal infections, is affected by various factors, particularly in allogeneic hematopoietic cell transplantation (allo‐HCT) recipients. Patients receiving allo‐HCT also receive immunoglobulin replacement therapy (IgRT); however, little is known about the effects of different types of immunoglobulin products on serum β‐D‐glucans. Here, we examined the levels of serum β‐D‐glucan following IgRT, as well as the correlation between changes in serum β‐D‐glucan and IgG levels. Methods Serum β‐D‐glucan levels in patients who underwent allo‐HCT and IgRT at our institution between 2021 and 2024 were analyzed retrospectively. Patients who had their serum β‐D‐glucan measured within 7 days before and after IgRT were included, and changes in serum β‐D‐glucan levels were evaluated across product types. Finally, the magnitude of these changes was assessed using effect sizes. Results A total of 125 administrations of three types of immunoglobulin product (Privegen [ n =  63], Venoglobulin [ n  = 38], and Venilon‐I [ n  = 24]) were examined. The median dose of immunoglobulin was 538.9 (57.4–700.9) mg/kg. We noted a significant increase in serum β‐D‐glucan levels after administration of Privigen, with a large effect size (Cohen's dz  = 0.92; 95% confidence interval 0.48–1.35, p  < 0.01). No meaningful changes were detected with Venoglobulin or Venilon‐I. Elevated serum β‐D‐glucan levels returned to baseline within approximately 3 weeks of Privigen administration. Multivariable analysis indicated that Privigen was an independent factor associated with higher serum β‐D‐glucan levels. Conclusion Different immunoglobulin products have different effects on serum β‐D‐glucan levels after IgRT. image