Immunomodulatory effect of ibrutinib: Reducing the barrier against fungal infections.


Journal

Blood reviews
ISSN: 1532-1681
Titre abrégé: Blood Rev
Pays: England
ID NLM: 8708558

Informations de publication

Date de publication:
03 2020
Historique:
received: 04 01 2019
revised: 29 05 2019
accepted: 24 10 2019
pubmed: 9 11 2019
medline: 22 1 2021
entrez: 9 11 2019
Statut: ppublish

Résumé

The Bruton tyrosine kinase (BTK) inhibitor ibrutinib is increasingly used in the treatment of chronic lymphocytic leukemia (CLL). Moreover, very promising results have been reported in other B-cell malignancies, including primary central nervous system lymphoma (PCNSL). Although well-tolerated in the majority of patients, ibrutinib demonstrates in some cases troublesome toxicities, including invasive fungal infections (IFIs). In the present review, we summarize clinical manifestations of IFIs in patients treated with ibrutinib, generally characterized by an early onset, mild clinical manifestations, asymptomatic/low symptomatic pulmonary localization and high incidence of central nervous system (CNS) involvement. IFI risk appears particularly increased in patients receiving ibrutinib associated with other immune modulator agents, especially with steroids or immune-chemotherapy. Moreover, the immunomodulatory effect of ibrutinib is described, pointing the attention on the involvement of specific molecules targeted by ibrutinib in innate and adaptive response to fungal infection. Overall, the findings indicate the ibrutinib may rapidly impair innate immune cell functions, while concomitantly restoring an effective protective potential of adaptive immune compartment. A correct awareness, especially when other predisposing factors are present, is warranted about the potential risk of IFIs in ibrutinib-treated patients.

Identifiants

pubmed: 31699465
pii: S0268-960X(19)30149-3
doi: 10.1016/j.blre.2019.100635
pii:
doi:

Substances chimiques

Neoplasm Proteins 0
Piperidines 0
Protein Kinase Inhibitors 0
ibrutinib 1X70OSD4VX
Agammaglobulinaemia Tyrosine Kinase EC 2.7.10.2
BTK protein, human EC 2.7.10.2
Adenine JAC85A2161

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

100635

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest R.Mar. received research funding from Janssen and Gilead Sci and honoraria from Gilead Sci., Janssen, Abbvie, Roche and Shire. M.L received honoraria from Gilead Sci., MSD, Pfizer, Novartis, Abbvie, Sanofi, Daiichi Sankyo, Jazz Pharmaceuticals. R.Maf. has received speaker fee from Abbvie. L.A. has received travel grant from Abbvie and BMS. Other Authors have nothing to declare.

Auteurs

Rossana Maffei (R)

Hematology Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy; Hematology Unit, Department of Oncology, Hematology and Respiratory Diseases, A.O.U of Modena Policlinico, Italy. Electronic address: rossana.maffei@unimore.it.

Monica Maccaferri (M)

Hematology Unit, Department of Oncology, Hematology and Respiratory Diseases, A.O.U of Modena Policlinico, Italy.

Laura Arletti (L)

Hematology Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Stefania Fiorcari (S)

Hematology Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Stefania Benatti (S)

Hematology Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Leonardo Potenza (L)

Hematology Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Mario Luppi (M)

Hematology Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Roberto Marasca (R)

Hematology Unit, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy.

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Classifications MeSH