Early-onset invasive aspergillosis and other fungal infections in patients treated with ibrutinib

被引：250

作者：

Ghez, David ^{[1
]}

Calleja, Anne ^{[2
]}

Protin, Caroline ^{[3
]}

Baron, Marine ^{[4
]}

Ledoux, Marie-Pierre ^{[5
]}

Damaj, Gandhi ^{[6
]}

Dupont, Mathieu ^{[7
]}

Dreyfus, Brigitte ^{[8
]}

Ferrant, Emmanuelle ^{[9
]}

Herbaux, Charles ^{[10
]}

Laribi, Kamel ^{[11
]}

Le Calloch, Ronan ^{[12
]}

Malphettes, Marion ^{[13
]}

Paul, Franciane ^{[14
]}

Souchet, Laetitia ^{[4
]}

Truchan-Graczyk, Malgorzata ^{[15
]}

Delavigne, Karen ^{[16
]}

Dartigeas, Caroline ^{[17
]}

Ysebaert, Loic ^{[3
]}

机构：

[1] Gustave Roussy, Dept Hematol, 114 Rue Edouard Vaillant, F-94805 Villejuif, France

[2] Grp Hosp Archet, Serv Hematol, Nice, France

[3] Inst Univ Canc Toulouse Oncopole, Serv Hematol, Toulouse, France

[4] Hop La Pitie Salpetriere, Serv Hematol, Paris, France

[5] CHU Strasbourg, Hop Hautepierre, Serv Hematol & Oncol, Strasbourg, France

[6] Ctr Hosp Reg Univ, Serv Hematol, Caen, France

[7] Ctr Hosp St Malo, Serv Malad Infect, St Malo, France

[8] CHU Poitiers, Serv Hematol, Poitiers, France

[9] Ctr Hosp Lyon Sud, Serv Hematol, Pierre Benite, France

[10] CHU Lille, Serv Malad Sang, Hop Huriez, Lille, France

[11] Ctr Hosp Mans, Serv Hematol, Le Mans, France

[12] Ctr Hosp Cornouaille, Med Interne Malad Sang Malad Infect, Quimper, France

[13] Hop St Louis, Serv Immunohematol, Paris, France

[14] CHU Montpellier, Hop St Eloi, Serv Hematol, Montpellier, France

[15] Ctr Hosp Saumur, Serv Med, Saumur, France

[16] Inst Univ Canc Toulouse Oncopole, Serv Malad Infect, Toulouse, France

[17] CHU Tours, Serv Hematol & Therapie Cellulair, Hop Bretonneau, Tours, France

来源：

BLOOD | 2018年 / 131卷 / 17期

关键词：

EPIDEMIOLOGY; IMMUNITY; THERAPY; KINASE;

D O I：

10.1182/blood-2017-11-818286

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Ibrutinib has revolutionized the management of chronic lymphocytic leukemia and is now being increasingly used. Although considered to be less immunosuppressive than conventional immunochemotherapy, the observation of a few cases of invasive fungal infections in patients treated with ibrutinib prompted us to conduct a retrospective survey. We identified 33 cases of invasive fungal infections in patients receiving ibrutinib alone or in combination. Invasive aspergillosis (IA) was overrepresented (27/33) and was associated with cerebral localizations in 40% of the cases. Remarkably, most cases of invasive fungal infections occurred with a median of 3 months after starting ibrutinib. In 18/33 cases, other conditions that could have contributed to decreased antifungal responses, such as corticosteroids, neutropenia, or combined immunochemotherapy, were present. These observations indicate that ibrutinib may be associated with early-onset invasive fungal infections, in particular IA with frequent cerebral involvement, and that patients on ibrutinib should be closely monitored in particular when other risk factors of fungal infections are present.

引用

页码：1955 / 1959

页数：5

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