Risk of Infection Associated With Ibrutinib in Patients With B-Cell Malignancies: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Ball, Somedeb; Das, Avash; Vutthikraivit, Wasawat; Edwards, Peggy; Hardwicke, Fred; Short, Nicholas J.; Borthakur, Gautam; Maiti, Abhishek

doi:10.1016/j.clml.2019.10.004

Cited by 29 publications

(35 citation statements)

References 32 publications

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“…As a lower risk of infectious events was expected with targeted agents than chemoimmunotherapy, several reports have focused on infections in patients treated with ibrutinib [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Although several inhibitory effects exerted by ibrutinib on immune effector cells have been described to explain the increased fragility to infections (particularly fungal infections [35][36][37][38][39][40][41][42]), little is known about the prognostic impact of infections in patients treated with ibrutinib. Moreover, the role of clinical and biological factors in favoring infections in patients treated with ibrutinib should be better defined.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Impact and Risk Factors of Infections in Patients with Chronic Lymphocytic Leukemia Treated with Ibrutinib

Mauro

Giannarelli

Visentin

et al. 2021

Cancers

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Ibrutinib represents extraordinary progress in the treatment of chronic lymphocytic leukemia (CLL). However, treatment-related adverse events limit the benefit of this agent. This observational, multicenter study focused on the incidence, risk factors, and prognostic impact of infections in 494 patients with CLL treated with an ibrutinib-based treatment. Ibrutinib was given to 89 (18%) previously untreated patients (combined with rituximab, 24) and 405 (82%) relapsed/refractory patients. Pneumonia (PN), grade ≥3 non-opportunistic infections (NOI), and opportunistic infections (OI) were recorded in 32% of patients with an overall incidence rate per 100 person-year of 15.3% (PN, 10%; NOI, 3.3%; OI, 2%). Infections were the reason for the permanent discontinuation of ibrutinib in 9% of patients. Patients who experienced pneumonia or a severe infection showed a significantly inferior survival than those who were infection-free (p < 0.0001). A scoring system based on the three factors associated with a significant and independent impact on infections—PN or severe infection in the year before starting ibrutinib, chronic obstructive pulmonary disease, ≥2 prior treatments—identified patients with a two- to threefold increase in the rate of infections. In conclusion, the results of this study highlight the adverse impact of infectious events on the outcomes of CLL patients treated with ibrutinib.

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Section: Introductionmentioning

confidence: 99%

Prognostic Impact and Risk Factors of Infections in Patients with Chronic Lymphocytic Leukemia Treated with Ibrutinib

Mauro

Giannarelli

Visentin

et al. 2021

Cancers

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“…A recent meta-analysis reported an increased risk of both all-grade and grade 3 to 5 infectious complications in patients with B-cell malignancies taking ibrutinib compared with controls in randomized, controlled trials ( Ball et al, 2020 ). Despite this risk, there are currently no standard guidelines or recommendations for routine antimicrobial prophylaxis in patients receiving BTK inhibitors.…”

Section: Implications For the Advanced Practitionermentioning

confidence: 99%

A Review of the Bruton Tyrosine Kinase Inhibitors in B-Cell Malignancies

Moore¹,

Thompson²

2021

JADPRO

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The B-cell receptor signaling pathway plays an integral role in the proliferation and survival of malignant B cells. Targeting the B-cell receptor pathway via the inhibition of Bruton tyrosine kinase (BTK) has evolved the treatment of a variety of B-cell malignancies, including chronic lymphocytic leukemia, mantle cell lymphoma, marginal zone lymphoma, and Waldenström macroglobulinemia. Currently, there are three BTK inhibitors approved by the U.S. Food and Drug Administration: ibrutinib, acalabrutinib, and zanubrutinib. This article reviews the pharmacology, clinical efficacy, safety, dosing, drug-drug interactions, and implications for advanced practitioners of BTK inhibitors in the treatment of B-cell malignancies.

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“…BTK, a key signaling molecule in B-cell receptor and NF-kB signaling pathway, is constitutively activated in ABC-DLBCL due aberrant genetic alterations [44]. Ibrutinib, an irreversible inhibitor of BTK, is an established therapeutic agent in a variety of B-cell lymphoproliferative disorders.…”

Section: Treatmentmentioning

confidence: 99%

Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg Type: A Narrative Review

Parker¹,

Al-Obaidi²,

D³

et al. 2020

COR

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Primary cutaneous lymphomas are rare manifestations of extranodal lymphomas. Comprising the majority of cutaneous lymphoma cases with neoplastic B-cell origins, three main subtypes exist. In general, grossly and microscopically these subtypes are similar. However, these are three distinct variants with diverse clinicopathologic, cytogenetic, molecular, and prognostic features. Primary cutaneous diffuse large B-cell lymphoma, leg type is an exceedingly rare and aggressive variant of primary cutaneous B-cell lymphomas. Thus, increased clinical awareness is needed to differentiate between the three subtypes because earlier identification not only leads to the appropriate treatment, but also improved survival. Here, characteristic features of the three predominant variants of primary cutaneous B-cell lymphomas are presented while remaining focused on the most aggressive subtype- primary cutaneous diffuse large B-cell lymphoma, leg type.

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Risk of Infection Associated With Ibrutinib in Patients With B-Cell Malignancies: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Cited by 29 publications

References 32 publications

Prognostic Impact and Risk Factors of Infections in Patients with Chronic Lymphocytic Leukemia Treated with Ibrutinib

Prognostic Impact and Risk Factors of Infections in Patients with Chronic Lymphocytic Leukemia Treated with Ibrutinib

A Review of the Bruton Tyrosine Kinase Inhibitors in B-Cell Malignancies

Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg Type: A Narrative Review

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