Cryptococcal infections in two patients receiving ibrutinib therapy for chronic lymphocytic leukemia.

Cryptococcal infections are responsible for significant morbidity and mortality in immunocompromised patients. Reports of these infections in patients on small molecular kinase inhibitors have not been widely reported in clinical trials. We describe one case of cryptococcal meningoencephalitis and o...

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Publicado en:Journal of Oncology Pharmacy Practice Vol. 25; no. 3; pp. 710 - 715
Autores principales: Stankowicz, Matthew, Banaszynski, Megan, Crawford, Russell
Formato: case study tables/charts Journal Article
Publicado: Sage Publications Inc. Apr2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2019
      vid: 25
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      pub: Sage Publications Inc.
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        atl: Cryptococcal infections in two patients receiving ibrutinib therapy for chronic lymphocytic leukemia.
      aug:
        au:
          Stankowicz, Matthew
          Banaszynski, Megan
          Crawford, Russell
        affil: Southern Arizona VA Health Care System, Tucson, AZ, USA
      sug:
        subj:
          Immunocompromised Host
          Meningitis, Cryptococcal Etiology
          Cryptococcus
          Pneumonia
          Tyrosine Kinase Inhibitors Therapeutic Use
          Leukemia, Lymphocytic, Chronic
          Tyrosine Kinase Inhibitors Adverse Effects
          Atrial Fibrillation
          Aged
          Male
          Antigens Analysis
          Aged: 65+ years
          Male
      ab: Cryptococcal infections are responsible for significant morbidity and mortality in immunocompromised patients. Reports of these infections in patients on small molecular kinase inhibitors have not been widely reported in clinical trials. We describe one case of cryptococcal meningoencephalitis and one case of cryptococcal pneumonia in two patients who were receiving ibrutinib for chronic lymphocytic leukemia. Despite different sites of cryptococcal infection, both patients had similar presentations of acute illness. Patient 1 was worked up for health care–associated pneumonia, as well as acute sinusitis prior to the diagnosis of cryptococcal meningoencephalitis. He also had a more complex past medical history than patient 2. Patient 2 developed atrial fibrillation from ibrutinib prior to admission for presumed health care–associated pneumonia. Cryptococcal antigen testing was done sooner in this patient due to patient receiving high-dose steroids for the treatment of underlying hemolytic anemia. We conclude that patients who develop acute illness while receiving ibrutinib should be considered for cryptococcal antigen testing.
      pubtype: Academic Journal
      doctype:
        case study
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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