Managing infectious challenges in the age of molecular-targeted therapies for adult hematological malignancies

Transpl Infect Dis. 2024 Jun;26(3):e14283. doi: 10.1111/tid.14283. Epub 2024 May 2.

Abstract

Over the last decade, the therapeutic landscape for hematological malignancies (HMs) has witnessed a remarkable surge in the development of novel biological and small-molecule-targeted immunomodulatory agents. These therapies have drastically improved survival, but some come at the cost of increased risk of bacterial, viral, and/or fungal infections and on-target off-tumor immunological side effects. To mitigate such risks, physicians must be well informed about infectious complications and necessary preventive measures, such as screening, vaccinations, and antimicrobial prophylaxis. Furthermore, physicians should be vigilant about the noninfectious side effects of these agents that can mimic infections and understand their potential drug-drug interactions with antimicrobials. Strengthening and harmonizing the current surveillance and reporting system for drug-associated infections in real-world settings is essential to better ascertain the potential infections associated with these agents. In this review, we aimed to summarize the infection risks associated with novel agents used for specific HMs and outline recommended strategies for monitoring and prophylaxis.

Keywords: hematologic malignancies; hematopoietic stem cell transplantation; infection; small‐molecule inhibitors; targeted therapies.

Publication types

  • Review

MeSH terms

  • Adult
  • Hematologic Neoplasms* / complications
  • Hematologic Neoplasms* / drug therapy
  • Humans
  • Molecular Targeted Therapy* / methods
  • Mycoses / drug therapy
  • Mycoses / prevention & control