B-cell defects

• Hypogammaglobulinemia

• Poor response to vaccination

T-cell defects

• Quantitative: increased numbers

• Qualitative

  • Skewed repertoire, decreased CD4/8 ratio

  • Th 2 polarization

  • Abnormal CD30 response

  • Reversible acquired CD40L deficiency

  • Gene expression abnormalities (cytoskeleton, granules)

NK cell

• lack of granules

• reduced killing activity

Neutrophils

• reduced phagocytic and bactericidal function

• abnormal migration and chemotaxis

Monocytes/macrophages

• reduced cytotoxcity

Complement

• reduction in levels and defects in activation and binding

Bone marrow failure due to advanced disease

Toxicity (myeloid and lymphoid) due to therapy