ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an infectious diseases perspective (Intracellular signaling pathways: tyrosine kinase and mTOR inhibitors)

Abstract

Specific preventive approaches are warranted in view of the increased risk of infection associated with some of the reviewed agents.

<p>Prevention Strategies to Minimize the Infection Risk Associated with Biologic and Targeted Immunomodulators</p>

“…This study reviewed and summarized prevention strategies, including screening, monitoring, immunization, prophylaxis, and management of infections associated with about 70 biologic and targeted therapies based on relevant guidelines, especially ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus document series published in 2018. [8][9][10][11][12][13] in preventing HBV reactivation in patients on anti-CD20 monoclonal antibodies. 32,33 Therefore, ESCMID recommends either tenofovir or entecavir-based regimens for antiviral therapy in both active and occult hepatitis B patients who are candidates for anti-CD20 targeted agents.…”

“…The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Infections in Compromised Hosts Consensus have reviewed articles and made recommendations to instruct clinicians on the strategies to prevent and manage infections associated with biologic and targeted immunomodulators. [8][9][10][11][12][13] In this review, we aim to focus on evidence-based strategies according to the latest guidelines to provide practitioners guidance regarding screening, chemoprophylaxis, vaccination, and management of infections in patients on biologic and targeted immunomodulators.…”

Acute leukemia in the time of COVID-19

“…Venetoclax is a highly selective, oral, B cell leukemia/ lymphoma 2 (BCL-2) inhibitor with demonstrated efficacy in AML patients either alone or in combination with 5-azacitidine or decitabine [18]. However, prolonged neutropenia with increased risks of bacterial or fungal lung infections, is observed in AML patients treated with venetoclax [19]. Since this combined treatment is most frequently indicated in elderly AML patients unfit for intensive therapy and allogeneic transplantation, the risk of respiratory failure may be highly increased if they contract COVID-19.…”

A journey through infectious risk associated with ruxolitinib

“…Recently, the European Conference on Infections in Leukaemia (ECIL) (Maschmeyer et al , ) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Infections in Compromised Hosts (ESGICH) (Reinwald et al , ) reviewed the safety profile of a wide range of targeted agents and immunotherapeutic drugs, including ruxolitinib; both papers provided a critical state‐of‐the‐art on infectious complications associated with their use, and suggested some preventive recommendations. As with many other new targeted and/or immunomodulating drugs that are currently in use for the treatment of haematological malignancies, it is now well established that clinicians need to be aware and vigilant of the risk of infections, and need to be especially proactive in treating any episodes.…”

“…Even though screening for latent TB is not considered mandatory (Reinwald et al , ; Maschmeyer et al , ), we screen every patient who is a candidate for ruxolitinib, because we deem that the risk of missing a patient who may benefit from prophylaxis is not negligible, from a clinical point of view.…”