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Observational Study
. 2021 Apr;193(2):316-324.
doi: 10.1111/bjh.17145. Epub 2020 Oct 15.

Infections in patients with lymphoproliferative diseases treated with targeted agents: SEIFEM multicentric retrospective study

Gessica Marchesini  1 , Gianpaolo Nadali  1 , Davide Facchinelli  1 , Anna Candoni  2 , Chiara Cattaneo  3 , Luca Laurenti  4 , Rosa Fanci  5 , Francesca Farina  6 , Federica Lessi  7 , Andrea Visentin  7 , Francesco Marchesi  8 , Lucia Prezioso  9 , Angelica Spolzino  9 , Maria Chiara Tisi  10 , Fabio Trastulli  11 , Marika Picardi  4 , Luisa Verga  12 , Michelina Dargenio  13 , Alessandro Busca  14 , Livio Pagano  4 ; for Sorveglianza Epidemiologica Infezioni nelle Emopatie (SEIFEM)
Affiliations
Observational Study

Infections in patients with lymphoproliferative diseases treated with targeted agents: SEIFEM multicentric retrospective study

Gessica Marchesini et al. Br J Haematol. 2021 Apr.

Abstract

We describe the opportunistic infections occurring in 362 patients with lymphoproliferative disorders treated with ibrutinib and idelalisib in clinical practice. Overall, 108 of 362 patients (29·8%) developed infections, for a total of 152 events. Clinically defined infections (CDI) were 49·3% (75/152) and microbiologically defined infections (MDI) were 50·7% (77/152). Among 250 patients treated with ibrutinib, 28·8% (72/250) experienced one or more infections, for a total of 104 episodes. MDI were 49% (51/104). Bacterial infections were 66·7% (34/51), viral 19·6% (10/51) and invasive fungal diseases (IFD) 13·7% (7/51). Among the 112 patients treated with idelalisib, 32·1% (36/112) experienced one or more infections, for a total of 48 episodes. MDI were 54·2% (26/48). Bacterial infections were 34·6% (9/26), viral 61·5% (16/26) and IFD 3·8% (1/26). With ibrutinib, the rate of bacterial infections was significantly higher compared to idelalisib (66·7% vs. 34·6%; P = 0·007), while viral infections were most frequent in idelalisib (61·5% vs. 19·6%; P < 0·001). Although a higher rate of IFD was observed in patients treated with ibrutinib, the difference was not statistically significant (13·7% vs. 3·8% respectively; P = 0·18). Bacteria are the most frequent infections with ibrutinib, while viruses are most frequently involved with idelalisib.

Keywords: infections; lymphoproliferative diseases; targeted therapy.

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Conflict of interest statement

All other authors report no potential conflict.

Figures

Fig 1
Fig 1
Cumulative incidence of infections. (A) 250 patients treated with ibrutinib of which 72 experienced infections (104 events). Median time to first infection: 148·2 days (range 3–830); (B) 112 patients treated with idelalisib of which 36 experienced infections (48 events). Median time to first infection: 175 days (range 9–690). [Colour figure can be viewed at wileyonlinelibrary.com]
Fig 2
Fig 2
Rates and etiology of infections. (A) 104 infective episodes in 72 patients treated with ibrutinib; (B) 48 infective episodes in 36 patients treated with idelalisib. n indicates the number of infective episodes.
See this image and copyright information in PMC

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