Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy.
ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Crit Rev Oncol Hematol. 2024 Sep;201:104408. doi: 10.1016/j.critrevonc.2024.104408. Epub 2024 Jun 14.
Bruton tyrosine kinase inhibitors (BTKi) and the BCL-2 inhibitor venetoclax have significantly improved the prognosis of patients with chronic lymphocytic leukemia (CLL). However, the incidence of severe infections in patients receiving these agents needs to be better understood. Our review aimed to provide an overview of grade ≥3 infections in patients with CLL who received BTKi and venetoclax-based therapy in prospective trials. Infection rates were influenced by the age of patients and the duration of follow-up. For treatment-naive (TN) patients receiving BTKi, infection rates ranged between 11.4 % and 27.4 % and were close to 30 % in relapsed/refractory (R/R) patients. TN and R/R patients receiving fixed-duration venetoclax-based treatments showed variable rates, with maximum values around 20 %. Opportunistic and fatal infections were uncommon. In conclusion, infections remain a concern in patients with CLL receiving targeted agents. A better definition of factors increasing infection vulnerability could help identify those patients who require infection prophylaxis.
布鲁顿酪氨酸激酶抑制剂 (BTKi) 和 BCL-2 抑制剂 Venetoclax 显著改善了慢性淋巴细胞白血病 (CLL) 患者的预后。然而，接受这些药物治疗的患者严重感染的发生率仍需进一步了解。我们的综述旨在提供 CLL 患者在接受前瞻性试验中接受 BTKi 和 Venetoclax 为基础的治疗时，出现≥3 级感染的概述。感染率受患者年龄和随访时间的影响。对于接受 BTKi 治疗的初治（TN）患者，感染率在 11.4%至 27.4%之间，而在复发/难治（R/R）患者中接近 30%。接受固定疗程 Venetoclax 为基础治疗的 TN 和 R/R 患者的感染率有所不同，最高值约为 20%。机会性感染和致死性感染并不常见。总之，接受靶向治疗的 CLL 患者仍存在感染问题。更好地定义增加感染易感性的因素可能有助于识别需要预防感染的患者。
