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. 2019 Dec 5;27:17–21. doi: 10.1016/j.mmcr.2019.12.007

Table 3.

Summary of CNS aspergillosis cases in patients treated with ibrutinib.

Study Patient Prior Oncologic Treatment Aspergillus Species Time from Ibrutinib Initiation to Diagnosis of CNS Aspergillosis (months) Antifungal Treatment Patient Outcome at Time of Publication
Gaye et al. [17] Patient 1: CLL Obinituzumab, chlorambucil, rituximab, bendamustine A. fumigatus <1 Voriconazole; ibrutinib discontinued Alive
Patient 2: CLL Corticosteroids A. fumigatus 2 Voriconazole and amphotericin B; ibrutinib continued Alive
Ruchlemer et al. [18] Patient 1: CLL Corticosteroids NR 1 NR Dead
Patient 2: CLL Corticosteroids NR 2 LAMB and voriconazole; ibrutinib discontinued Alive
Patient 3: CLL Corticosteroids NR 2 NR Alive
Jain et al. [19] CLL Rituximab NR 2 NR Deceased
Baron et al. [3] CLL Fludarabine, CP, rituximab A. nidulans <1 Voriconazole; ibrutinib discontinued Alive
Beresford et al. [20] CLL Fludarabine, CP, bendamustine, rituximab A. fumigatus 12 Voriconazole subsequently switched to posaconazole; ibrutinib discontinued Alive
Ghez et al. [13] 11 patients Median number of prior therapies: 2 NR Median 3 monthsb NR NR: Total mortality 52% for all patients with IFI
Ruchlemer et al. [6] 9 patients; CLLa or NHL Median number of prior therapies: 3 (no patients were treatment-naïve prior to starting ibrutinib) NR Median 1.5 monthsb NR NR: Total mortality 69% for all patients with IFI (including those with non-CNS disease)
Lionakis et al. [14] Patient 1: PCNSL Corticosteroids A. fumigatus <1 NR Deceased
Patient 2: PCNSL 4 prior therapies, Corticosteroids, on TEDDi-R A. fumigatus <1 Deceased
Patient 3: PCNSL 4 cycles TEDDi-R A. fumigatus 3 Deceased
Patient 4: PCNSL Corticosteroids; 1 cycle TEDDi-R A. fumigatus <1 Alive
Present Case 62yo M CLL None A. fumigatus <1 Voriconazole, ibrutinib discontinued Alive

CLL chronic lymphocytic leukemia; NR not reported; LAMB liposomal amphotericin B; NHL Non-Hodgkin Lymphoma; PCNSL Primary CNS Lymphoma; CP cyclophosphamide, TEDDi-R Temozolomide, Etoposide, Doxil, Dexamethasone, Ibrutinib, and Rituximab.

a

2 of the patients included in this study were also included in reference [21].

b

Analysis included all patients with IFI on ibrutinib regardless of site of infection.