Invasive Fungal Disease Associated With Targeted Agents for Acute Myeloid Leukaemia: A Systematic Review

Objective: To examine the incidence of invasive fungal disease (IFD) in patients receiving targeted agents for acute myeloid leukaemia (AML). Methods: Literature for this systematic review was identified through a PubMed search in April 2024, using AML, IFD and targeted therapy terms. The following filters were applied: published in the last 10 years and published in English. Results: The PubMed search yielded 54 results, of which 16 were deemed relevant for inclusion. Four additional references were identified through manual searches. The majority of publications focused on the incidence of IFD during treatment with targeted agents; the remainder focused on the efficacy of targeted treatments and reported IFD as an adverse event. Most publications were retrospective analyses. Prophylaxis use and agents differed across studies. In several studies, IFD incidence was above the 8% threshold identified for anti-mould prophylaxis. Aspergillus was the most commonly reported pathogen, and most IFD cases occurred in the lungs. Conclusions: IFD is relatively common among patients with AML receiving targeted therapies, despite the use of prophylaxis. Prospective studies with detailed IFD reporting, together with large epidemiological studies, are required to better understand the risk factors for, and incidence and nature of IFD in this patient population.