» Articles » PMID: 36291806

Infectious Complications of Targeted Therapies in Children with Leukemias and Lymphomas

Overview
Journal Cancers (Basel)
Publisher MDPI
Specialty Oncology
Date 2022 Oct 27
PMID 36291806
Authors
Affiliations
Soon will be listed here.
Abstract

The aim of this review is to highlight mechanisms of immunosuppression for each agent, along with pooled analyses of infectious complications from the available medical literature. Rituximab confers no increase in grade ≥3 infectious risks, except in the case of patients with advanced-stage non-Hodgkin lymphoma. Gemtuzumab ozogamicin links with high rates of grade ≥3 infections which, however, are comparable with historical cohorts. Pembrolizumab exhibits a favorable safety profile in terms of severe infections. Despite high rates of hypogammaglobulinemia (HGG) with blinatumomab, low-grade ≥3 infection rates were observed, especially in the post-reinduction therapy of relapsed B-acute lymphoblastic leukemia. Imatinib and nilotinib are generally devoid of severe infectious complications, but dasatinib may slightly increase the risk of opportunistic infections. Data on crizotinib and pan-Trk inhibitors entrectinib and larotrectinib are limited. CAR T-cell therapy with tisagenlecleucel is associated with grade ≥3 infections in children and is linked with HGG and the emergence of immune-related adverse events. Off-label therapies inotuzumab ozogamicin, brentuximab vedotin, and venetoclax demonstrate low rates of treatment-related grade ≥3 infections, while the addition of bortezomib to standard chemotherapy in T-cell malignancies seems to decrease the infection risk during induction. Prophylaxis, immune reconstitution, and vaccinations for each targeted agent are discussed, along with comparisons to adult studies.

Citing Articles

Invasive Fungal Disease After Chimeric Antigen Receptor-T Immunotherapy in Adult and Pediatric Patients.

Evangelidis P, Tragiannidis K, Vyzantiadis A, Evangelidis N, Kalmoukos P, Vyzantiadis T Pathogens. 2025; 14(2).

PMID: 40005545 PMC: 11858289. DOI: 10.3390/pathogens14020170.


Benchmarking miRNA reference genes in B-cell precursor acute lymphoblastic leukemia.

Mack T, Gianferri T, Niedermayer A, Debatin K, Meyer L, Muench V Sci Rep. 2024; 14(1):26390.

PMID: 39488607 PMC: 11531470. DOI: 10.1038/s41598-024-77733-8.


Complete Remission with Inotuzumab Ozogamicin as Fourth-Line Salvage Therapy in a Child with Relapsed/Refractory Acute Lymphoblastic Leukemia.

Tragiannidis A, Antari V, Tsotridou E, Sidiropoulos T, Kaisari A, Palabougiouki M Hematol Rep. 2024; 16(4):579-584.

PMID: 39449299 PMC: 11503335. DOI: 10.3390/hematolrep16040056.


Epidemiology of Invasive Fungal Diseases: A 10-Year Experience in a Tertiary Pediatric Hematology-Oncology Department in Greece.

Moraitaki E, Kyriakidis I, Pelagiadis I, Katzilakis N, Stratigaki M, Chamilos G J Fungi (Basel). 2024; 10(7).

PMID: 39057383 PMC: 11278103. DOI: 10.3390/jof10070498.


B-NHL Cases in a Tertiary Pediatric Hematology-Oncology Department: A 20-Year Retrospective Cohort Study.

Kyriakidis I, Pelagiadis I, Stratigaki M, Katzilakis N, Stiakaki E Life (Basel). 2024; 14(5).

PMID: 38792653 PMC: 11122206. DOI: 10.3390/life14050633.


References
1.
El-Alfy M, Al-Haddad A, Hamed A . Management of CML in the Pediatric Age Group: Imatinib Mesylate or SCT. J Egypt Natl Canc Inst. 2011; 22(4):227-32. View

2.
Maude S, Laetsch T, Buechner J, Rives S, Boyer M, Bittencourt H . Tisagenlecleucel in Children and Young Adults with B-Cell Lymphoblastic Leukemia. N Engl J Med. 2018; 378(5):439-448. PMC: 5996391. DOI: 10.1056/NEJMoa1709866. View

3.
Cole P, McCarten K, Pei Q, Spira M, Metzger M, Drachtman R . Brentuximab vedotin with gemcitabine for paediatric and young adult patients with relapsed or refractory Hodgkin's lymphoma (AHOD1221): a Children's Oncology Group, multicentre single-arm, phase 1-2 trial. Lancet Oncol. 2018; 19(9):1229-1238. PMC: 6487196. DOI: 10.1016/S1470-2045(18)30426-1. View

4.
Brethon B, Yakouben K, Oudot C, Boutard P, Bruno B, Jerome C . Efficacy of fractionated gemtuzumab ozogamicin combined with cytarabine in advanced childhood myeloid leukaemia. Br J Haematol. 2008; 143(4):541-7. DOI: 10.1111/j.1365-2141.2008.07370.x. View

5.
Hasegawa D, Yoshimoto Y, Kimura S, Kumamoto T, Maeda N, Hara J . Bortezomib-containing therapy in Japanese children with relapsed acute lymphoblastic leukemia. Int J Hematol. 2019; 110(5):627-634. DOI: 10.1007/s12185-019-02714-x. View