Risk of Severe Infections Secondary to the Use of Targeted Therapies in Hematological Malignancies

Abstract

Concurrent infections in hematological malignancies (HM) are major contributors to adverse clinical outcomes, including prolonged hospitalization and reduced life expectancy. Individuals diagnosed with HM are particularly susceptible to infectious pathogens due to immunosuppression, which can either be inherent to the hematological disorder or induced by specific therapeutic therapies. Over the years, the treatment paradigm for HM has witnessed a tremendous shift from broad-spectrum treatment approaches to more specific, targeted therapies. Even now, the therapeutic landscape of HM is constantly evolving due to the advent of novel targeted therapies and enhanced utilization of these agents for treatment purposes. By initiating unique molecular pathways, these agents hinder the proliferation of malignant cells, consequently affecting innate and adaptive immunity, which increases the risk of infectious complications. Due to the complexity of novel targeted therapies and their associated risk of infection, it often becomes a daunting task for physicians to maintain updated knowledge in their clinical practice. The situation is further aggravated by the fact that most of the initial clinical trials on targeted therapies provide inadequate information to conclude the associated risk of infection. In such a scenario, a cumulative body of evidence is paramount for guiding clinicians regarding the infectious complications that can arise following targeted therapies. In this review, I summarize the recent knowledge on infectious complications arising in targeted therapies for HM.