Oral azole antifungal prophylaxis in Japanese patients with chronic lymphocytic leukemia receiving ibrutinib: a nationwide cohort study
Oral azole antifungal prophylaxis in Japanese patients with chronic lymphocytic leukemia receiving ibrutinib: a nationwide cohort study
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接受依鲁替尼治疗的日本慢性淋巴细胞白血病患者口服唑类抗真菌药物预防：一项全国性队列研究
DOI：
10.1080/10428194.2022.2161305
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Akazawa Manabu
中科院分区：
文献类型：
--
作者：
Yasu Takeo;Sakurai Kotono;Hoshino Makoto;Akazawa Manabu
依鲁替尼是第一代 BrutonLs 酪氨酸激酶抑制剂，是慢性淋巴细胞白血病 (CLL) 的重要治疗选择[1, 2]。然而，有报道称使用依鲁替尼会导致侵袭性真菌感染（IFIs），例如侵袭性曲霉菌病、耶氏肺孢子菌肺炎（PJP）和隐球菌病[3-6]。最近的报告表明，依鲁替尼可抑制巨噬细胞反应，强调了某些 IFI 易感性的潜在机制 [3, 7]。因此，伊布替尼被提议作为 IFI 的新诱发因素，并被欧洲癌症/真菌病研究与治疗组织研究组添加为可能的侵袭性肺霉菌病定义中的宿主因素 [8]。然而，接受依鲁替尼治疗的患者中 IFI 的临床危险因素尚未阐明。预防性施用唑类抗真菌剂对抗真菌（例如念珠菌和曲霉）的有效性也是未知的。值得注意的是，已经建议使用甲氧苄氨嘧啶-磺胺甲恶唑来预防 PJP [8]。我们的目的是使用真实世界的索赔数据库确定唑类抗真菌药物对接受依鲁替尼治疗的 CLL 患者的 IFI（不包括 PJP）的预防效果。这是一项使用 Medical Data Vision 管理索赔数据库的真实世界回顾性队列研究，该数据库是一个全国性数据库，由使用诊断程序组合 (DPC) 系统的日本急症护理医院的数据组成。 2008年4月至2019年12月期间，共有258,565名使用国际疾病分类第10版（ICD-10）代码C81-C96和D46识别的血液恶性肿瘤患者在数据库中注册。对符合以下纳入标准的患者进行评估：（1）诊断为CLL（ICD-10代码：C911）的患者，（2）16岁以下的患者(3) 2008 年 4 月后诊断为 CLL 的患者。我们评估了接受口服唑类抗真菌药物预防的患者与未接受口服唑类抗真菌药物预防的患者之间除 PJP 之外的 IFI 发生率的差异。口服唑类预防被定义为至少
Ibrutinib, a first-generation inhibitor of BrutonLs tyrosine kinase, is an important treatment option in chronic lymphocytic leukemia (CLL)[1, 2]. However, there have been reports of invasive fungal infections (IFIs), such as invasive aspergillosis, Pneumocystis jirovecii pneumonia (PJP), and cryptococcosis, with the use of ibrutinib [3-6]. Recent reports have shown that ibrutinib inhibits macrophage responses, highlighting a potential mechanism for predisposition to certain IFIs [3, 7]. Therefore, ibrutinib has been proposed as a new predisposing factor for IFIs and has been added as a host factor in the definition of probable invasive pulmonary mold disease by the European Organization for Research and Treatment of Cancer/Mycosis Study Group [8]. However, clinical risk factors for IFIs have yet to be elucidated in patients treated with ibrutinib. The usefulness of prophylactic administration of azole antifungal agents against fungi, such as Candida and Aspergillus, is also unknown. Notably, prophylaxis with trimethoprim-sulfamethoxazole is already recommended against PJP [8]. We aimed to determine the prophylactic effect of azole antifungals on IFIs, excluding PJP, in ibrutinib-treated patients with CLL using a realworld claims database.This was a real-world, retrospective cohort study using the Medical Data Vision administrative claims database, which is a nationwide database consisting of data from Japanese acute care hospitals that utilize the Diagnosis Procedure Combination (DPC) system. A total of 258,565 patients with hematological malignancies, identified using International Classification of Diseases 10th revision (ICD-10) codes C81-C96 and D46, were registered in the database between April 2008 and December 2019. The patients who met the following inclusion criteria were evaluated:(1) those diagnosed with CLL (ICD-10 code: C911),(2) those 16years old, and (3) those diagnosed with CLL after April 2008. We evaluated differences in the incidence of IFIs, other than PJP, between patients who received oral azole antifungal prophylaxis and those who did not. Oral azole prophylaxis was defined as at least
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影响因子：
4
作者：
Muto R;Miyoshi H;Sato K;Furuta T;Muta H;Kawamoto K;Yanagida E;Yamada K;Ohshima K
通讯作者：
Ohshima K
DOI：
--
发表时间：
2020
期刊：
Definitions
影响因子：
--
作者：
Fang Liu;Zhen Li;Hongyu Wang;Yang Cao;Nan Zhang;Fang Wang;Rui Wei;Jian Zhang;Yuqian Zhao
通讯作者：
Yuqian Zhao
影响因子：
4.9
作者：
Ruchlemer, Rosa;Ben-Ami, Ronen;Lachish, Tamar
通讯作者：
Lachish, Tamar
DOI：
10.1056/nejmoa1215637
发表时间：
2013-07-04
期刊：
The New England journal of medicine
影响因子：
--
作者：
Byrd JC;Furman RR;Coutre SE;Flinn IW;Burger JA;Blum KA;Grant B;Sharman JP;Coleman M;Wierda WG;Jones JA;Zhao W;Heerema NA;Johnson AJ;Sukbuntherng J;Chang BY;Clow F;Hedrick E;Buggy JJ;James DF;O'Brien S
通讯作者：
O'Brien S