真菌感染与新型免疫治疗剂的使用有关。

IF 3.1 Q2 MICROBIOLOGY

Current Clinical Microbiology Reports Pub Date : 2020-12-01 Epub Date: 2020-09-26 DOI:10.1007/s40588-020-00154-4

Marilia Bernardes, Tobias M Hohl

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引用次数: 12

摘要

综述的目的:最近出现了关于免疫治疗引起感染的可能性的担忧。在这篇综述中，我们总结了目前关于免疫检查点抑制剂和嵌合抗原受体T细胞治疗期间发生的侵袭性真菌感染的文献。最近的发现:真菌感染是罕见的使用检查点抑制剂。大多数病例是由侵袭性曲霉病和肺囊虫肺炎引起的，发生在需要大剂量皮质类固醇治疗免疫相关不良事件的患者中。相反，真菌感染通常在CAR - T细胞治疗期间报道。大多数病例是由侵袭性曲霉病和念珠菌病引起的，可能是在调节方案或使用免疫抑制剂治疗细胞因子释放综合征和神经毒性后长期中性粒细胞减少的结果。摘要:需要长期免疫抑制剂的治疗相关毒性似乎在免疫治疗期间真菌感染的发展中起关键作用。需要进行持续监测，以充分解决这些新型药物引起真菌感染的风险。

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Fungal Infections Associated With the Use of Novel Immunotherapeutic Agents.

Purpose of the review: Recent concerns have emerged regarding the potential of immunotherapy to cause infection. In this review, we summarize the current literature on invasive fungal infections that occur during treatment with immune checkpoint inhibitors and chimeric antigen receptor T cell therapy.

Recent findings: Fungal infections are uncommon with the use of checkpoint inhibitors. Most cases are caused by invasive aspergillosis and pneumocystis pneumonia and occur in patients requiring high dose corticosteroids for the management of immune-related adverse events. Conversely, fungal infections are commonly reported during therapy with CAR T cells. Most cases are caused by invasive aspergillosis and candidiasis and are likely the result of prolonged neutropenia following the conditioning regimen or immunosuppressant use for the management of cytokine release syndrome and neurotoxicity.

Summary: Treatment-related toxicities that require prolonged immunosuppressive agents appear to play a key role in the development of fungal infections during immunotherapy. Ongoing surveillance is needed to fully address the risks of fungal infections with these novel agents.

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来源期刊

Current Clinical Microbiology Reports MICROBIOLOGY-

CiteScore

7.50

自引率

1.90%

发文量

期刊介绍： Current Clinical Microbiology Reports commissions expert reviews from leading scientists at the forefront of research in microbiology. The journal covers this broad field by dividing it into four key main areas of study: virology, bacteriology, parasitology, and mycology. Within each of the four sections, experts from around the world address important aspects of clinical microbiology such as immunology, diagnostics, therapeutics, antibiotics and antibiotic resistance, and vaccines. Some of the world’s foremost authorities in the field of microbiology serve as section editors and editorial board members. Section editors select topics for which leading researchers are invited to contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, which are highlighted in annotated reference lists. These timely reviews of the literature examine the latest scientific discoveries and controversies as they emerge and are indispensable to both researchers and clinicians. The editorial board, composed of more than 20 internationally diverse members, reviews the annual table of contents, ensures that topics address all aspects of emerging research, and where applicable suggests topics of critical importance to various countries/regions.