Non‐<i>Aspergillus</i> invasive mould infections in patients treated with ibrutinib

Anastasopoulou, Amalia; DiPippo, Adam J; Kontoyiannis, Dimitrios P.

doi:10.1111/myc.13120

Cited by 18 publications

(7 citation statements)

References 48 publications

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“…Epidemiologic studies reported an increase in the incidence IFD in patients with CLPDs receiving ibrutinib, especially invasive aspergillosis (IA) [25]. However, other IFDs, including invasive fusariosis, have also been diagnosed in such patients [26,27].…”

Section: Settingmentioning

confidence: 99%

Invasive Fusariosis in Patients with Hematologic Diseases

Nucci

Barreiros

Akiti

et al. 2021

JoF

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Fusarium species are filamentous fungi widely encountered in nature, and may cause invasive disease in patients with hematologic conditions. Patients at higher risk are those with acute leukemia receiving induction remission chemotherapy or allogeneic hematopoietic cell transplant recipients. In these hosts, invasive fusariosis presents typically with disseminated disease, fever, metastatic skin lesions, pneumonia, and positive blood cultures. The prognosis is poor and the outcome is largely dependent on the immune status of the host, with virtually a 100% death rate in persistently neutropenic patients, despite monotherapy or combination antifungal therapy. In this paper, we will review the epidemiology, clinical manifestations, diagnosis, and management of invasive fusariosis affecting patients with hematologic diseases.

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Section: Settingmentioning

confidence: 99%

Invasive Fusariosis in Patients with Hematologic Diseases

Nucci

Barreiros

Akiti

et al. 2021

JoF

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“…However, in recent years, IFD has been increasingly reported in other populations, such as those with acute lymphoblastic leukaemia, lymphoma or multiple myeloma. This holds especially true in those patients who have received multiple prior lines of treatment [ 17 , 18 ]. IFD epidemiology in patients with haematological malignancies has been highly influenced by the widespread introduction of antifungal prophylaxis in high-risk populations [ 2 ].…”

Section: Non- Aspergillus Mould Infections In Spec...mentioning

confidence: 99%

Non-Aspergillusmould lung infections

Puerta‐Alcalde

García-Vidal²

2022

Eur Respir Rev

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Non-Aspergillusfilamentous fungi causing invasive mould infections have increased over the last years due to the widespread use of anti-Aspergillusprophylaxis and increased complexity and survival of immunosuppressed patients. In the few studies that have reported on invasive mould infection epidemiology, Mucorales are the most frequently isolated group, followed by eitherFusariumspp. orScedosporiumspp. The overall incidence is low, but related mortality is exceedingly high. Patients with haematological malignancies and haematopoietic stem cell transplant recipients comprise the classical groups at risk of infection for non-Aspergillusmoulds due to profound immunosuppression and the vast use of anti-Aspergillusprophylaxis. Solid organ transplant recipients also face a high risk, especially those receiving lung transplants, due to direct exposure of the graft to mould spores with altered mechanical and immunological elimination, and intense, associated immunosuppression. Diagnosing non-Aspergillusmoulds is challenging due to unspecific symptoms and radiological findings, lack of specific biomarkers, and low sensitivity of cultures. However, the advent of molecular techniques may prove helpful. Mucormycosis, fusariosis and scedosporiosis hold some differences regarding clinical paradigmatic presentations and preferred antifungal therapy. Surgery might be an option, especially in mucormycosis. Finally, various promising strategies to restore or enhance the host immune response are under current evaluation.

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“…28 Fungal infections, although rarely reported in clinical trials, have also been associated with the use of ibrutinib in several observational studies; 13,[28][29][30][31][32] the most common causative agent was Aspergillus spp., although non-Aspergillus infections have also been reported. 33 Inhibition of the BTK pathway in macrophages involved in the defence against fungi may play a role. 32,34 Fungal infections typically appear during the first 6 months of treatment, in patients who have received previous antineoplastic treatment, and in those receiving glucocorticoids.…”

Section: Bruton Tyrosine Kinase Inhibitorsmentioning

confidence: 99%

Risk of infection associated with targeted therapies for solid organ and hematological malignancies

Ruiz‐Camps

Aguilar-Company

2021

Therapeutic Advances in Infection

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Higher risks of infection are associated with some targeted drugs used to treat solid organ and hematological malignancies, and an individual patient’s risk of infection is strongly influenced by underlying diseases and concomitant or prior treatments. This review focuses on risk levels and specific suggestions for management, analyzing groups of agents associated with a significant effect on the risk of infection. Due to limited clinical experience and ongoing advances in these therapies, recommendations may be revised in the near future. Bruton tyrosine kinase (BTK) inhibitors are associated with a higher rate of infections, including invasive fungal infection, especially in the first months of treatment and in patients with advanced, pretreated disease. Phosphatidylinositol 3-kinase (PI3K) inhibitors are associated with an increased risk of Pneumocystis pneumonia and cytomegalovirus (CMV) reactivation. Venetoclax is associated with cytopenias, respiratory infections, and fever and neutropenia. Janus kinase (JAK) inhibitors may predispose patients to opportunistic and fungal infections; need for prophylaxis should be assessed on an individual basis. Mammalian target of rapamycin (mTOR) inhibitors have been linked to a higher risk of general and opportunistic infections. Breakpoint cluster region-Abelson (BCR-ABL) inhibitors are associated with neutropenia, especially over the first months of treatment. Anti-CD20 agents may cause defects in the adaptative immune response, hypogammaglobulinemia, neutropenia, and hepatitis B reactivation. Alemtuzumab is associated with profound and long-lasting immunosuppression; screening is recommended for latent infections and prevention strategies against CMV, herpesvirus, and Pneumocystis infections. Checkpoint inhibitors (CIs) may cause immune-related adverse events for which prolonged treatment with corticosteroids is needed: prophylaxis against Pneumocystis is recommended.

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Non‐Aspergillus invasive mould infections in patients treated with ibrutinib

Cited by 18 publications

References 48 publications

Invasive Fusariosis in Patients with Hematologic Diseases

Invasive Fusariosis in Patients with Hematologic Diseases

Non-Aspergillusmould lung infections

Risk of infection associated with targeted therapies for solid organ and hematological malignancies

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