Non-Aspergillus invasive mould infections in patients treated with ibrutinib

Mycoses. 2020 Aug;63(8):787-793. doi: 10.1111/myc.13120. Epub 2020 Jun 19.

Abstract

Background: Invasive mould infections (IMIs) are very rare in patients with lymphoid malignancies. However, IMIs, mostly due to Aspergillus species, have been increasingly reported in such patients receiving ibrutinib (IBR). There is paucity of information regarding non-Aspergillus invasive mould infections (NAIMIs) in this setting, OBJECTIVES: To review our recent experience and the published literature on the topic.

Patients/methods: We present a case of invasive sinusitis caused by Fusarium in a patient with refractory chronic lymphocytic leukaemia (CLL) who was treated with IBR and review the 12 published cases of NAIMIs during IBR.

Results: Nearly all cases of NAIMIs in the setting of IBR use were encountered in patients with CLL. Mixed fungal infections, brain involvement and late-onset infections were common.

Conclusions: Although rare, NAIMIs should be considered in patients who receive IBR.

Keywords: Mucorales; Ibrutinib; chronic lymphocytic leukaemia; non-Aspergillus moulds.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenine / adverse effects
  • Adenine / analogs & derivatives*
  • Aged
  • Anticarcinogenic Agents / adverse effects
  • Antifungal Agents / therapeutic use
  • Aspergillosis* / drug therapy
  • Aspergillosis* / etiology
  • Aspergillus / isolation & purification
  • Aspergillus / pathogenicity
  • Female
  • Fungi / isolation & purification
  • Fungi / pathogenicity
  • Fusariosis / drug therapy
  • Fusariosis / etiology
  • Fusarium / isolation & purification
  • Fusarium / pathogenicity
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / complications*
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy
  • Mucorales / isolation & purification
  • Mucorales / pathogenicity
  • Mycoses / etiology*
  • Piperidines / adverse effects*

Substances

  • Anticarcinogenic Agents
  • Antifungal Agents
  • Piperidines
  • ibrutinib
  • Adenine