Fungal infection in patients treated with Bruton's Tyrosine Kinase inhibitor, from epidemiology to clinical outcome: A systematic review
Abstract
BACKGROUND
Bruton Tyrosine Kinase inhibitor (BTKi) emerged as key treatment for B-cell lymphomas. Despite its efficacy in the treatment of malignancies, numerous cases of invasive fungal infections (IFI) have been reported in patients receiving ibrutinib, a first generation BTKi. Cases of invasive aspergillosis have also been reported with acalabrutinib and zanubrutinib.
OBJECTIVES
The objective was to provide an overview of the pathogens involved, the time of onset of infections and factors influencing survival.
METHODS
DATA SOURCES
PubMed, Embase and Web of Science databases were used and the results were reported according to PRISMA guidelines.
STUDY ELIGIBILITY CRITERIA
Case reports, case series, clinical trials and cohort studies were included.
PARTICIPANTS
All reported cases of IFI in patients treated with BTKi were analyzed. For case reports/case series, demographic, microbiological and outcome data were retrieved.
ASSESSMENT OF RISK OF BIAS
Given the significant heterogeneity in clinical trials/cohort studies, no formal incidence analysis was performed, only epidemiological analysis.
METHODS OF DATA SYNTHESIS
Epidemiologic data were presented as descriptive statistics.
RESULTS
25,215 patients from 92 retrospective and prospective clinical trials/cohort studies and 211 patients from 115 case reports/case series were included. Among clinical trials/cohorts, 736 IFI were reported, including 234 candidiasis (31.8%), 227 aspergillosis (30.8%), and 124 PJP (16.8%). Among…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 25,215 participants or records.
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