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成人血液系统恶性肿瘤分子靶向治疗时代的感染管理挑战。

Managing infectious challenges in the age of molecular-targeted therapies for adult hematological malignancies.

机构信息

Division of Hematology and Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA.

Division of Hematology and Oncology, Department of Medicine, The University of Virginia, Charlottesville, Virginia, USA.

出版信息

Transpl Infect Dis. 2024 Jun;26(3):e14283. doi: 10.1111/tid.14283. Epub 2024 May 2.

Abstract

Over the last decade, the therapeutic landscape for hematological malignancies (HMs) has witnessed a remarkable surge in the development of novel biological and small-molecule-targeted immunomodulatory agents. These therapies have drastically improved survival, but some come at the cost of increased risk of bacterial, viral, and/or fungal infections and on-target off-tumor immunological side effects. To mitigate such risks, physicians must be well informed about infectious complications and necessary preventive measures, such as screening, vaccinations, and antimicrobial prophylaxis. Furthermore, physicians should be vigilant about the noninfectious side effects of these agents that can mimic infections and understand their potential drug-drug interactions with antimicrobials. Strengthening and harmonizing the current surveillance and reporting system for drug-associated infections in real-world settings is essential to better ascertain the potential infections associated with these agents. In this review, we aimed to summarize the infection risks associated with novel agents used for specific HMs and outline recommended strategies for monitoring and prophylaxis.

摘要

在过去的十年中,血液系统恶性肿瘤(HMs)的治疗领域见证了新型生物制剂和小分子靶向免疫调节剂的显著发展。这些疗法极大地提高了生存率,但有些疗法会增加细菌、病毒和/或真菌感染的风险,以及针对肿瘤的免疫副作用。为了降低这些风险,医生必须充分了解感染并发症和必要的预防措施,如筛查、疫苗接种和抗菌预防。此外,医生应该警惕这些药物的非感染性副作用,这些副作用可能模仿感染,并了解它们与抗菌药物的潜在药物相互作用。加强和协调目前现实环境中与药物相关感染的监测和报告系统对于更好地确定与这些药物相关的潜在感染至关重要。在这篇综述中,我们旨在总结新型药物与特定 HMs 相关的感染风险,并概述监测和预防的建议策略。

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