High rates of proven invasive fungal disease with the use of ibrutinib monotherapy for relapsed or refractory chronic lymphocytic leukemia

Teh, Benjamin W; Chui, William; Handunnetti, Sasanka; Tam, Constantine S.; Worth, Leon J; Thursky, Karin; Slavin, Monica A

doi:10.1080/10428194.2018.1543884

Cited by 21 publications

(18 citation statements)

References 15 publications

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“…We identified twelve reports that describe patients with NAIMIs while on IBR therapy (Table 1). 13,[18][19][20][21][22][23][24][25][26] In our review, nearly all of IBR-treated patients with NAIMIs had CLL (12/13, 92%). Most patients were males (11/13, 85%), and their age ranged from 52 to 79 years (median 68 years).…”

Section: Liter Ature Re Vie W Of Non -A Sperg Illus Inva S Ive Moulmentioning

confidence: 66%

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Non‐Aspergillus invasive mould infections in patients treated with ibrutinib

Anastasopoulou

DiPippo

Kontoyiannis

2020

Mycoses

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Summary Background Invasive mould infections (IMIs) are very rare in patients with lymphoid malignancies. However, IMIs, mostly due to Aspergillus species, have been increasingly reported in such patients receiving ibrutinib (IBR). There is paucity of information regarding non‐Aspergillus invasive mould infections (NAIMIs) in this setting, Objectives To review our recent experience and the published literature on the topic. Patients/Methods We present a case of invasive sinusitis caused by Fusarium in a patient with refractory chronic lymphocytic leukaemia (CLL) who was treated with IBR and review the 12 published cases of NAIMIs during IBR. Results Nearly all cases of NAIMIs in the setting of IBR use were encountered in patients with CLL. Mixed fungal infections, brain involvement and late‐onset infections were common. Conclusions Although rare, NAIMIs should be considered in patients who receive IBR.

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Section: Liter Ature Re Vie W Of Non -A Sperg Illus Inva S Ive Moulmentioning

confidence: 66%

“…We identified twelve reports that describe patients with NAIMIs while on IBR therapy (Table 1). 13,18‐26 …”

Section: Literature Review Of Non‐aspergillus Invasive Mould Infectiomentioning

confidence: 99%

Non‐Aspergillus invasive mould infections in patients treated with ibrutinib

Anastasopoulou

DiPippo

Kontoyiannis

2020

Mycoses

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“…Fungal infections, although rarely reported in clinical trials, have also been associated with the use of ibrutinib in several observational studies; 13 , 28 – 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.…”

Section: Methodsmentioning

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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“…The Bruton tyrosine kinase (Btk) inhibitor ibrutinib, used in the treatment of mantle cell lymphoma and chronic lymphocytic leukemia, has been associated with invasive fungal diseases with frequent involvement of the CNS. Specifically, intracerebral invasive aspergillosis and, to a lesser extent, cryptococcosis and Pneumocystis jirovecii pneumonia were reported [34,35,36,37,38,39]. Few cases of mucormycosis have been described so far in patients receiving ibrutinib [40,41,42].…”

Section: Epidemiologymentioning

confidence: 99%

Mucormycosis of the Central Nervous System

Chikley

Ben‐Ami

Kontoyiannis

2019

JoF

104

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Mucormycosis involves the central nervous system by direct extension from infected paranasal sinuses or hematogenous dissemination from the lungs. Incidence rates of this rare disease seem to be rising, with a shift from the rhino-orbital-cerebral syndrome typical of patients with diabetes mellitus and ketoacidosis, to disseminated disease in patients with hematological malignancies. We present our current understanding of the pathobiology, clinical features, and diagnostic and treatment strategies of cerebral mucormycosis. Despite advances in imaging and the availability of novel drugs, cerebral mucormycosis continues to be associated with high rates of death and disability. Emerging molecular diagnostics, advances in experimental systems and the establishment of large patient registries are key components of ongoing efforts to provide a timely diagnosis and effective treatment to patients with cerebral mucormycosis.

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High rates of proven invasive fungal disease with the use of ibrutinib monotherapy for relapsed or refractory chronic lymphocytic leukemia

Cited by 21 publications

References 15 publications

Non‐Aspergillus invasive mould infections in patients treated with ibrutinib

Non‐Aspergillus invasive mould infections in patients treated with ibrutinib

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

Mucormycosis of the Central Nervous System

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