Ibrutinib and tracheal mucormycosis: A case report and systematic review of literature

IF 2.2 4区医学 Q3 MYCOLOGY Journal de mycologie medicale Pub Date : 2023-08-01 DOI:10.1016/j.mycmed.2023.101414

Vikram Damaraju , Ritesh Agarwal , Inderpaul Singh Sehgal , Alka Khadwal , Amanjit Bal , Shivaprakash Mandya Rudramurthy , Valliappan Muthu

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引用次数: 1

Abstract

Ibrutinib, a Bruton tyrosine kinase (BTK) inhibitor, has been approved for various hematological malignancies. Invasive aspergillosis is a known complication of ibrutinib, but mucormycosis is rare. We describe the case of a 70-year-old man with mantle cell lymphoma infiltrating the trachea, managed with a tracheobronchial stent and ibrutinib. He had improved one month after treatment, and we removed the airway stent. Four months later, he developed tracheal nodules confirmed to be tracheal mucormycosis and responded to liposomal amphotericin B (3.5 g) followed by posaconazole. After transient improvement, the tracheal lesions recurred, the biopsy showed lymphoma (with no evidence of mucormycosis), and he died. A systematic review of the literature identified 20 additional cases of ibrutinib-associated mucormycosis. Most of the 21 patients included were men (95%), and ibrutinib was the only risk factor in 15.7%. The reported mortality was 31.6% (6/19), attributable to mucormycosis in half the cases.

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伊鲁替尼与气管毛霉病:1例报告及文献系统回顾

伊布替尼是一种布鲁顿酪氨酸激酶（BTK）抑制剂，已被批准用于各种血液系统恶性肿瘤。侵袭性曲霉菌病是伊布替尼的一种已知并发症，但毛霉菌病很少见。我们描述了一例70岁的男性外套管细胞淋巴瘤浸润气管，用气管支气管支架和伊布替尼治疗。治疗一个月后，他的病情有所好转，我们移除了气道支架。四个月后，他出现了气管结节，证实是气管毛霉菌病，并对两性霉素B脂质体（3.5克）和泊沙康唑有反应。在短暂好转后，气管病变复发，活检显示淋巴瘤（没有毛霉菌病的证据），他去世了。对文献的系统回顾确定了另外20例与伊布替尼相关的毛霉菌病。纳入的21名患者中，大多数是男性（95%），伊布替尼是唯一的危险因素，占15.7%。报告的死亡率为31.6%（6/19），半数病例可归因于毛霉菌病。

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来源期刊

Journal de mycologie medicale 医学-真菌学

CiteScore

5.10

自引率

2.80%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal de Mycologie Medicale / Journal of Medical Mycology (JMM) publishes in English works dealing with human and animal mycology. The subjects treated are focused in particular on clinical, diagnostic, epidemiological, immunological, medical, pathological, preventive or therapeutic aspects of mycoses. Also covered are basic aspects linked primarily with morphology (electronic and photonic microscopy), physiology, biochemistry, cellular and molecular biology, immunochemistry, genetics, taxonomy or phylogeny of pathogenic or opportunistic fungi and actinomycetes in humans or animals. Studies of natural products showing inhibitory activity against pathogenic fungi cannot be considered without chemical characterization and identification of the compounds responsible for the inhibitory activity. JMM publishes (guest) editorials, original articles, reviews (and minireviews), case reports, technical notes, letters to the editor and information. Only clinical cases with real originality (new species, new clinical present action, new geographical localization, etc.), and fully documented (identification methods, results, etc.), will be considered. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.