Current therapies for chronic lymphocytic leukemia: risk and prophylaxis strategies for secondary/opportunistic infections

References

• Cancer.org [Internet]. American Cancer Society: cancer Facts and Figures 2021. American Cancer Society, 2021. Available from: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2021.html.
   Google Scholar
• Nowakowski GS, Hoyer JD, Shanafelt TD, et al. Using smudge cells on routine blood smears to predict clinical outcome in chronic lymphocytic leukemia: a universally available prognostic test. Mayo Clin Proc. 2007 Apr;82(4):449–453.
   PubMedGoogle Scholar
• Hallek M, Cheson BD, Catovsky D, et al. iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL. Blood. 2018 Jun 21;131(25):2745–2760.
   PubMed Web of Science ®Google Scholar
• Arruga F, Gyau BB, Iannello A, et al. Immune Response Dysfunction in Chronic Lymphocytic Leukemia: dissecting Molecular Mechanisms and Microenvironmental Conditions. Int J Mol Sci. 2020 [Published 2020 Mar 6];21(5):1825. DOI:10.3390/ijms21051825
   PubMed Web of Science ®Google Scholar
• Griggio V, Perutelli F, Salvetti C, et al. Immune dysfunctions and immune-based therapeutic interventions in chronic lymphocytic leukemia. Front Immunol. 2020 Nov 18;11:594556.
   PubMedGoogle Scholar
• Rossi D, De Paoli L, Rossi FM, et al. Early stage chronic lymphocytic leukaemia carrying unmutated IGHV genes is at risk of recurrent infections during watch and wait. Br J Haematol. 2008;141:734–736.
   PubMed Web of Science ®Google Scholar
• Stauder R, Eichhorst B, Hamaker ME, et al. Management of chronic lymphocytic leukemia (CLL) in the elderly: a position paper from an international Society of Geriatric Oncology (SIOG) Task Force. Ann Oncol. 2017 Feb 1;28(2):218–227.
   PubMed Web of Science ®Google Scholar
• Fulop T, Larbi A, Kotb R, et al. Aging, immunity, and cancer. Discov Med. 2011;11(61):537–550.
   PubMedGoogle Scholar
• Pera A, Campos C, López N, et al. Immunosenescence: implications for response to infection and vaccination in older people. Maturitas. 2015 Sep;82(1):50–55.
   PubMedGoogle Scholar
• Maskarinec SA, Thaden JT, Cyr DD, et al. The risk of cardiac device-related infection in bacteremic patients is species specific: results of a 12-year prospective cohort. Open Forum Infect Dis. 2017 Jun 21;4(3):ofx132.
   PubMedGoogle Scholar
• Dufour S, Piroth L, Chirouze C, et al. Staphylococcus aureus bloodstream infection in patients with prosthetic joints in the prospective VIRSTA Cohort Study: frequency and Time of Occurrence of Periprosthetic Joint Infection. Open Forum Infect Dis. 2019 Dec 5;6(12):ofz515.
   PubMedGoogle Scholar
• Grywalska E, Zaborek M, Łyczba J, et al. Chronic lymphocytic leukemia-induced humoral immunosuppression: a systematic review. Cells. 2020;9(11):2398. DOI:10.3390/cells9112398
   PubMedGoogle Scholar
• Forconi F, Moss P. Perturbation of the normal immune system in patients with CLL. Blood. 2015;126(5):573–581.
   PubMed Web of Science ®Google Scholar
• Tsiodras S, Samonis G, Keating MJ, et al. Infection and immunity in chronic lymphocytic leukemia. Mayo Clin Proc. 2000;75:1039–1054.
   PubMed Web of Science ®Google Scholar
• Patel SY, Carbone J, Jolles S. The expanding field of secondary antibody deficiency: causes, diagnosis, and management. Front Immunol. 2019;10:33.
   PubMed Web of Science ®Google Scholar
• Sánchez-Ramón S, Dhalla F, Chapel H. Challenges in the role of gammaglobulin replacement therapy and vaccination strategies for hematological malignancy. Front Immunol. 2016 Aug 22;7:317. DOI:10.3389/fimmu.2016.00317
   PubMed Web of Science ®Google Scholar
• Compagno N, Cinetto F, Semenzato G, et al. Subcutaneous immunoglobulin in lymphoproliferative disorders and rituximab-related secondary hypogammaglobulinemia: a single-center experience in 61 patients. Haematologica. 2014;99(6):1101–1106.
   PubMed Web of Science ®Google Scholar
• Mustafa SS, Jamshed S, Vadamalai K, et al. Subcutaneous immunoglobulin replacement for treatment of humoral immune dysfunction in patients with chronic lymphocytic leukemia. PLoS ONE. 2021 Oct 15;16(10):e0258529.
   PubMed Web of Science ®Google Scholar
• Hilal T, Gea-Banacloche JC, Leis JF. Chronic lymphocytic leukemia and infection risk in the era of targeted therapies: linking mechanisms with infections. Blood Rev. 2018 Sep;32(5):387–399.
   PubMed Web of Science ®Google Scholar
• Maschmeyer G, De Greef J, Mellinghoff SC, et al. European Conference on Infections in Leukemia (ECIL). Infections associated with immunotherapeutic and molecular targeted agents in hematology and oncology. A position paper by the European Conference on Infections in Leukemia (ECIL). Leukemia. 2019 Apr;33(4):844–862.
   PubMed Web of Science ®Google Scholar
• Morrison VA, Rai KR, Peterson BL, et al. Impact of therapy with chlorambucil, fludarabine, or fludarabine plus chlorambucil on infections in patients with chronic lymphocytic leukemia: intergroup Study Cancer and Leukemia Group B 9011. J Clin Oncol. 2001;19(16):3611–3621. DOI:10.1200/JCO.2001.19.16.3611
   PubMedGoogle Scholar
• LeBien TW, Tedder TF. B lymphocytes: how they develop and function. Blood. 2008 Sep 1;112(5):1570–1580.
   PubMed Web of Science ®Google Scholar
• Mikulska M, Lanini S, Gudiol C, et al. ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an infectious diseases perspective (Agents targeting lymphoid cells surface antigens [I]: cD19, CD20 and CD52). Clin Microbiol Infect. 2018 Jun;24 Suppl 2:S71–82.
   PubMedGoogle Scholar
• Wen T, Wang J, Shi Y, et al. Inhibitors targeting Bruton’s tyrosine kinase in cancers: drug development advances. Leukemia. 2021 Feb;35(2):312–332.
   PubMed Web of Science ®Google Scholar
• Jongstra-Bilen J, Puig Cano A, Hasija M, et al. Dual functions of Bruton’s tyrosine kinase and Tec kinase during Fcγ receptor-induced signaling and phagocytosis. J Immunol. 2008;181:288–298.
   PubMed Web of Science ®Google Scholar
• Lionakis MS, Dunleavy K, Roschewski M, et al. Inhibition of B cell receptor signaling by ibrutinib in primary CNS lymphoma. Cancer Cell. 2017;31:833–843.e5.
   PubMed Web of Science ®Google Scholar
• Tsukada S, Saffran DC, Rawlings DJ, et al. Deficient expression of a B cell cytoplasmic tyrosine kinase in human X-linked agammaglobulinemia. Cell. 1993;72:279–290.
   PubMed Web of Science ®Google Scholar
• Ball S, Das A, Vutthikraivit W, et al. Risk of infection associated with ibrutinib in patients with B-cell malignancies: a systematic review and meta-analysis of randomized controlled Trials. Clin Lymphoma Myeloma Leuk. 2020 Feb;20(2):87–97.e5. DOI:10.1016/j.clml.2019.10.004
   PubMedGoogle Scholar
• Maertens JA, Girmenia C, Brüggemann RJ, et al. European guidelines for primary antifungal prophylaxis in adult haematology patients: summary of the updated recommendations from the European Conference on Infections in Leukaemia. J Antimicrob Chemother. 2018 Dec 1;73(12):3221–3230.
   PubMed Web of Science ®Google Scholar
• Holowka T, Cheung H, Malinis M, et al. Incidence and associated risk factors for invasive fungal infections and other serious infections in patients on ibrutinib. J Infect Chemother. 2021 Dec;27(12):1700–1705.
   PubMedGoogle Scholar
• Little JS, Weiss ZF, Hammond SP. Invasive fungal infections and targeted therapies in hematological malignancies. J Fungi. 2021;7:1058.
   Google Scholar
• Stilgenbauer S, Eichhorst B, Schetelig J, et al. Venetoclax in relapsed or refractory chronic lymphocytic leukaemia with 17p deletion: a multicentre, open-label, phase 2 study. Lancet Oncol. 2016;17:768–778.
   PubMed Web of Science ®Google Scholar
• Herman SE, Lapalombella R, Gordon AL, et al. The role of phosphatidylinositol 3-kinase-δ in the immunomodulatory effects of lenalidomide in chronic lymphocytic leukemia. Blood. 2011;117:4323–4327.
   PubMed Web of Science ®Google Scholar
• Reinwald M, Silva JT, Mueller NJ, et al. ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an infectious diseases perspective (Intracellular signaling pathways: tyrosine kinase and mTOR inhibitors). Clin Microbiol Infect. 2018 Jun;24 Suppl 2:S53–70.
   PubMedGoogle Scholar
• Xie S, Chen M, Yan B, et al. Identification of a role for the PI3K/AKT/mTOR signaling pathway in innate immune cells. PLoS ONE. 2014;9:e94496.
   PubMed Web of Science ®Google Scholar
• Ganzel C, Silverman B, Chemtob D, et al. The risk of tuberculosis in cancer patients is greatest in lymphoma and myelodysplastic syndrome/myeloproliferative neoplasm: a large population-based cohort study Leukemia & Lymphoma. 2019;60(3):720–725. DOI:10.1080/10428194.2018.1499904
   Google Scholar
• Henze L, Buhl C, Sandherr M, et al. Management of herpesvirus reactivations in patients with solid tumours and hematologic malignancies: update of the Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) on herpes simplex virus type 1, herpes simplex virus type 2, and varicella zoster virus. Ann Hematol. 2022;101:491–511.
   PubMed Web of Science ®Google Scholar
• Martin-Garrido I, Carmona EM, Specks U, et al. Pneumocystis pneumonia in patients treated with rituximab. Chest. 2013;144(1):258–265.
   PubMed Web of Science ®Google Scholar
• Bavaro DF, Fiordelisi D, Angarano G, et al. Targeted therapies for autoimmune/idiopathic nonmalignant diseases: risk and management of opportunistic infections. Expert Opin Drug Saf. 2020 Jul;19(7):817–842.
   PubMed Web of Science ®Google Scholar
• Mikulska M, Cesaro S, de Lavallade H, et al. Vaccination of patients with haematological malignancies who did not have transplantations: guidelines from the 2017 European Conference on Infections in Leukaemia (ECIL 7). Lancet Infect Dis. 2019 Jun;19(6):e188–199.
   PubMed Web of Science ®Google Scholar
• Din MAU, Liaqat H, Anwer F. Vaccine responses in patients with chronic lymphocytic leukemia on treatment with Bruton Tyrosine Kinase Inhibitors: a focused review. Hematol Transfus Cell Ther. 2022 Apr;44(2):293–296.
   PubMedGoogle Scholar
• Tsigrelis C, Ljungman P. Vaccinations in patients with hematological malignancies. Blood Rev. 2016 Mar;30(2):139–147.
   PubMed Web of Science ®Google Scholar
• Freedman MS, Hunter P, Ault K, et al. Advisory committee on immunization practices recommended immunization schedule for adults aged 19 years or older - United States, 2020. MMWR Morb Mortal Wkly Rep. 2020 Feb 7;69(5):133–135.
   PubMed Web of Science ®Google Scholar
• Pleyer C, Cohen J, Soto S, et al. Response to the Shingrix Varicella Zoster Virus (VZV) Vaccine in Patients with Chronic Lymphocytic Leukemia (CLL) That are Treatment Naive or Treated with a Bruton’s Tyrosine Kinase Inhibitor (BTK-I). Blood. 2019;134(Supplement_1):3053. DOI:10.1182/blood-2019-121675
   Google Scholar
• Bianco E, Marcucci F, Mele A, et al. Italian Multi-Center case-control study. Prevalence of hepatitis C virus infection in lymphoproliferative diseases other than B-cell non-Hodgkin’s lymphoma, and in myeloproliferative diseases: an Italian Multi-Center case-control study. Haematologica. 2004 Jan;89(1):70–76.
   PubMedGoogle Scholar
• Torres HA, Hosry J, Mahale P, et al. Hepatitis C virus reactivation in patients receiving cancer treatment: a prospective observational study. Hepatology. 2018 Jan;67(1):36–47.
   PubMed Web of Science ®Google Scholar
• Yazici O, Sendur MA, Aksoy S. Hepatitis C virus reactivation in cancer patients in the era of targeted therapies. World J Gastroenterol. 2014 Jun 14;20(22):6716–6724.
   PubMed Web of Science ®Google Scholar
• Kyvernitakis A, Mahale P, Popat UR, et al. Hepatitis C virus infection in patients undergoing hematopoietic cell transplantation in the era of direct-acting antiviral agents. Biol Blood Marrow Transplant. 2016;22(4):717–722. DOI:10.1016/j.bbmt.2015.12.010
   PubMed Web of Science ®Google Scholar
• Torres HA, McDonald GB. How I treat hepatitis C virus infection in patients with hematologic malignancies. Blood. 2016 Sep 15;128(11):1449–1457.
   PubMedGoogle Scholar
• Lazarus JV, Wiktor S, Colombo M, et al. EASL International Liver Foundation. Micro-elimination - a path to global elimination of hepatitis C. J Hepatol. 2017 Oct;67(4):665–666.
   PubMed Web of Science ®Google Scholar
• Zannella A, Marignani M, Begini P. Hematological Malignancies and HBV Reactivation Risk: suggestions for Clinical Management. Viruses. 2019;11(9):858.
   PubMedGoogle Scholar
• Voican CS, Mir O, Loulergue P, et al. Hepatitis B virus reactivation in patients with solid tumors receiving systemic anticancer treatment. Ann Oncol. 2016 Dec;27(12):2172–2184.
   PubMed Web of Science ®Google Scholar
• Liang TJ, Block TM, McMahon BJ, et al. Present and future therapies of hepatitis B: from discovery to cure. Hepatology. 2015;62:1893–1908.
   PubMed Web of Science ®Google Scholar
• Seeger C, Mason WS. Molecular biology of hepatitis B virus infection. Virology. 2015;479–480:672–686.
   PubMed Web of Science ®Google Scholar
• Loomba R, Liang TJ. Hepatitis B reactivation associated with immune suppressive and biological modifier therapies: current concepts, management strategies, and future directions. Gastroenterology. 2017 May;152(6):1297–1309.
   PubMed Web of Science ®Google Scholar
• Lampertico P, Agarwal K, Berg T, et al. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2017 Aug;67(2):370–398. DOI:10.1016/j.jhep.2017.03.021
   PubMed Web of Science ®Google Scholar
• Paul S, Dickstein A, Saxena A, et al. Role of surface antibody in hepatitis b reactivation in patients with resolved infection and hematologic malignancy: a meta-analysis. Hepatology. 2017;66:379–388.
   PubMed Web of Science ®Google Scholar
• Sandherr M, Hentrich M, von Lilienfeld-Toal M, et al. Antiviral prophylaxis in patients with solid tumours and haematological malignancies–update of the Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO). Ann Hematol. 2015 Sep;94(9):1441–1450.
   PubMed Web of Science ®Google Scholar
• Busca A, Cattaneo C, De Carolis E, et al. Considerations on antimicrobial prophylaxis in patients with lymphoproliferative diseases: a SEIFEM group position paper. Crit Rev Oncol Hematol. 2021 Feb;158:103203.
   PubMedGoogle Scholar
• Cheon J, Kim C, Park EJ, et al. Active tuberculosis risk associated with malignancies: an 18-year retrospective cohort study in Korea. J Thorac Dis. 2020 Sep;12(9):4950–4959.
   PubMedGoogle Scholar
• Cheng MP, Abou Chakra CN, Yansouni CP, et al. Risk of active tuberculosis in patients with cancer: a systematic review and meta-analysis. Clin Infect Dis. 2017 Mar 1;64(5):635–644.
   PubMed Web of Science ®Google Scholar
• Silva FA, Matos JO, de Q Mello FC, et al. Risk factors for and attributable mortality from tuberculosis in patients with hematologic malignances. Haematologica. 2005 Aug;90(8):1110–1115.
   PubMedGoogle Scholar
• Sánchez-García EM, Gamallo R, Blanco-Moure A, et al. Toxicity and adherence to treatment for latent tuberculosis infection in patients with hematologic malignancies. Infection. 2013 Oct;41(5):903–907.
   PubMedGoogle Scholar
• Buch MH, Smolen JS, Betteridge N, et al. Rituximab Consensus Expert Committee. Updated consensus statement on the use of rituximab in patients with rheumatoid arthritis. Ann Rheum Dis. 2011 Jun;70(6):909–920.
   PubMed Web of Science ®Google Scholar
• Zinzani PL, Rambaldi A, Gaidano G, et al. Infection control in patients treated for chronic lymphocytic leukemia with ibrutinib or idelalisib: recommendations from Italian society of hematology. Leuk Res. 2019 Jun;81:88–94.
   PubMedGoogle Scholar
• Traoré S, Roumila M, Eftekhari P, et al. Highlights on the risk of pulmonary tuberculosis in patients on ibrutinib treatment: case report and literature review. eJHaem. 2020;1:601–603.
   PubMedGoogle Scholar
• Wang SY, Ebert T, Jaekel N, et al. Miliary tuberculosis after initiation of ibrutinib in chronic lymphocytic leukemia. Ann Hematol. 2015;201594:1419–1420.
   Google Scholar
• Khera P, Haught JM, McSorley J, et al. Atypical presentations of herpesvirus infections in patients with chronic lymphocytic leukemia. J Am Acad Dermatol. 2009;60(3):484–486. DOI:10.1016/j.jaad.2008.08.047
   PubMedGoogle Scholar
• Schoen MW, Sanfilippo KM, Thomas TS, et al. Risk of herpes zoster in patients with chronic lymphocytic leukemia treated with fludarabine or bendamustine. Blood. 2017;130(Supplement 1):2174.
   Google Scholar
• Allen JM, Rybicki LA, Caimi PF, et al. Standard duration of varicella zoster virus prophylaxis may be inadequate to prevent viral reactivation in patients with chronic lymphocytic leukemia treated with frontline bendamustine plus rituximab. Blood. 2015;126(23):4167. DOI:10.1182/blood.V126.23.4167.4167
   Google Scholar
• Dagnew AF, Ilhan O, Lee WS, et al. Zoster-039 study group. Immunogenicity and safety of the adjuvanted recombinant zoster vaccine in adults with haematological malignancies: a phase 3, randomised, clinical trial and post-hoc efficacy analysis. Lancet Infect Dis. 2019 Sep;19(9):988–1000.
   PubMed Web of Science ®Google Scholar
• Antao N, Chilkulwar AR, Luo S, et al. Herpes zoster in chronic lymphocytic leukemia: effect of vaccination and treatment. J Clin Oncol. 2021;39(15_suppl):7527. DOI:10.1200/JCO.2021.39.15_suppl.7527
   Google Scholar
• Ilyas S, Chandrasekar PH. Preventing varicella-zoster: advances with the recombinant zoster vaccine. Open Forum Infect Dis. 2020;7(7):ofaa274.
   PubMed Web of Science ®Google Scholar
• Styczynski J. Who is the patient at risk of CMV recurrence: a review of the current scientific evidence with a focus on hematopoietic cell transplantation. Infect Dis Ther. 2018 Mar;7(1):1–16.
   PubMed Web of Science ®Google Scholar
• Cheah CY, Fowler NH. Idelalisib in the management of lymphoma. Blood. 2016 Jul 21;128(3):331–336.
   PubMed Web of Science ®Google Scholar
• Reddy Y, Baig M, Kalva N, et al. Cytomegalovirus proctitis in a patient with chronic lymphocytic leukemia on ibrutinib therapy: a case report. Cureus. 2020 Apr 26;12(4):e7837.
   PubMedGoogle Scholar
• Wang M, Rule S, Zinzani PL, et al. Durable response with single-agent acalabrutinib in patients with relapsed or refractory mantle cell lymphoma. Leukemia. 2019;33:2762–2766.
   PubMed Web of Science ®Google Scholar
• Nucci M, Anaissie EJ. Prevention of Infections in Patients with Hematological Malignancies. In: Wiernik P, Dutcher J, Gertz M, editors. Neoplastic Diseases of the Blood. Cham: Springer; 2018. p. 1047–1062.
   Google Scholar
• Noriko I, Yoichi I, Chihiro A, et al. Prospective analysis of cytomegalovirus reactivation and the immune state of low-grade b-cell lymphoma patients treated with bendamustine. Blood. 2014;124(21):4411. DOI:10.1182/blood.V124.21.4411.4411
   Google Scholar
• Hasegawa T, Aisa Y, Shimazaki K, et al. Cytomegalovirus reactivation with bendamustine in patients with low-grade B-cell lymphoma. Ann Hematol. 2015;94:515–517.
   PubMed Web of Science ®Google Scholar
• Alanio A, Bretagne S. Pneumocystis jirovecii detection in asymptomatic patients: what does its natural history tell us? F1000res. 2017 [Published 2017 May 23];6:739. DOI:10.12688/f1000research.10619.1
   PubMedGoogle Scholar
• Springsted E, Giri B, Kollipara V. Pneumocystis jirovecii pneumonia in newly diagnosed treatment-naïve chronic lymphocytic leukaemia BMJ Case Reports CP. BMJ Case Rep. 2021;14:e241888.
   PubMedGoogle Scholar
• Strich JR, Jerussi TD, Wiestner A, et al. Pneumocystis jirovecii pneumonia in a treatment-naive patient with chronic lymphocytic leukemia. Infect Dis Clin Pract (Baltim Md). 2016;24(6):e86–87. DOI:10.1097/IPC.0000000000000453
   PubMedGoogle Scholar
• Cordonnier C, Cesaro S, Maschmeyer G, et al. Fifth European Conference on Infections in Leukemia (ECIL-5), a joint venture of the European Group for Blood and Marrow Transplantation (EBMT), the European Organization for Research and Treatment of Cancer (EORTC), the Immunocompromised Host Society (ICHS) and the European LeukemiaNet (ELN). Pneumocystis jirovecii pneumonia: still a concern in patients with haematological malignancies and stem cell transplant recipients. J Antimicrob Chemother. 2016 Sep;71(9):2379–2385.
   PubMed Web of Science ®Google Scholar
• Vavricka SR, Halter J, Hechelhammer L, et al. Pneumocystis carinii pneumonia in chronic lymphocytic leukaemia Postgraduate. Medical Journal. 2004;80:236–238.
   Google Scholar
• Taplitz RA, Kennedy EB, Bow EJ, et al. Antimicrobial Prophylaxis for Adult Patients with Cancer-Related Immunosuppression: aSCO and IDSA Clinical Practice Guideline Update. J Clin Oncol. 2018 Oct 20;36(30):3043–3054.
   PubMed Web of Science ®Google Scholar
• Ahn IE, Jerussi T, Farooqui M, et al. Atypical Pneumocystis jirovecii pneumonia in previously untreated patients with CLL on single-agent ibrutinib. Blood. 2016 Oct 13;128(15):1940–1943.
   PubMed Web of Science ®Google Scholar
• Ryan CE, Cheng MP, Issa NC, et al. Pneumocystis jirovecii pneumonia and institutional prophylaxis practices in CLL patients treated with BTK inhibitors. Blood Adv. 2020;4(7):1458–1463. DOI:10.1182/bloodadvances.2020001678
   PubMed Web of Science ®Google Scholar
• Mato AR, Thompson M, Allan JN, et al. Real-world outcomes and management strategies for venetoclax-treated chronic lymphocytic leukemia patients in the United States. Haematologica. 2018 Sep;103(9):1511–1517.
   PubMed Web of Science ®Google Scholar
• Rogers KA, Mousa L, Zhao Q, et al. Incidence of opportunistic infections during ibrutinib treatment for B-cell malignancies. Leukemia. 2019 Oct;33(10):2527–2530.
   PubMed Web of Science ®Google Scholar
• Davis JS, Ferreira D, Paige E, et al. Infectious complications of biological and small molecule targeted immunomodulatory therapies. Clin Microbiol Rev. 2020 Jun 10;33(3):e00035.
   PubMed Web of Science ®Google Scholar
• Chatzikonstantinou T, Kapetanakis A, Scarfò L, et al. COVID-19 severity and mortality in patients with CLL: an update of the international ERIC and Campus CLL study. Leukemia. 2021;35(12):3444–3454. DOI:10.1038/s41375-021-01450-8
   PubMedGoogle Scholar
• Pagano L, Salmanton-García J, Marchesi F, et al. COVID-19 in vaccinated adult patients with hematological malignancies: preliminary results from EPICOVIDEHA. Blood. 2022 Mar 10;139(10):1588–1592.
   PubMedGoogle Scholar
• Seebacher, Seebacher NA. The antibody response of hematological malignancies to COVID-19 infection and vaccination. Br J Cancer. N.A;126(5):691–692.
   PubMedGoogle Scholar
• Herishanu Y, Werbel WA, Avery RK, et al. Efficacy of the BNT162b2 mRNA COVID-19 vaccine in patients with chronic lymphocytic leukemia. Blood. 2021;137(23):3165–3173. DOI:10.1182/blood.2021011568
   PubMed Web of Science ®Google Scholar
• Herzog Tzarfati K, Gutwein O, Apel A, et al. Bnt162b2 COVID-19 vaccine is significantly less effective in patients with hematologic malignancies. Am J Hematol. 2021;96:1195–1203.
   PubMed Web of Science ®Google Scholar
• Nguyen Y, Flahault A, Chavarot N, et al. Pre-exposure prophylaxis with tixagevimab and cilgavimab (Evusheld) for COVID-19 among 1112 severely immunocompromised patients. Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2022;28(12):.e1654.1–1654.4. DOI:10.1016/j.cmi.2022.07.015
   Google Scholar
• Levin MJ, Ustianowski A, De Wit S, et al. Intramuscular AZD7442 (Tixagevimab-Cilgavimab) for Prevention of Covid-19. N Engl J Med. 2022 Jun 9;386(23):2188–2200.
   PubMed Web of Science ®Google Scholar
• COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at https://www.covid19treatmentguidelines.nih.gov/. Accessed: Dec, 14th 2022
   Google Scholar
• Gottlieb RL, Vaca CE, Paredes R, et al. Early remdesivir to prevent progression to severe Covid-19 in outpatients. N Engl J Med. 2022;386:305–315.
   PubMed Web of Science ®Google Scholar
• Jayk Bernal A, da Silva Mm G, Musungaie DB, et al. Molnupiravir for oral treatment of Covid-19 in nonhospitalized patients. N Engl J Med. 2022 Feb 10;386(6):509–520.
   PubMed Web of Science ®Google Scholar
• Hammond J, Leister-Tebbe H, Gardner A, et al. Oral Nirmatrelvir for high-risk, nonhospitalized adults with Covid-19. N Engl J Med. 2022;386:1397–1408.
   PubMed Web of Science ®Google Scholar
• Dougan M, Nirula A, Azizad M, et al. Bamlanivimab plus Etesevimab in mild or moderate Covid-19. N Engl J Med. 2021;385:1382–1392.
   PubMed Web of Science ®Google Scholar
• Chen P, Nirula A, Heller B, et al. SARS-CoV-2 neutralizing antibody LY-Cov555 in outpatients with Covid-19. N Engl J Med. 2021;384:229–237.
   PubMed Web of Science ®Google Scholar
• Gupta A, Gonzalez-Rojas Y, Juarez E, et al. Early treatment for Covid-19 with SARS-CoV-2 neutralizing antibody sotrovimab. N Engl J Med. 2021;385:1941–1950.
   PubMed Web of Science ®Google Scholar
• Rivera D, Ferrajoli A. Managing the risk of infection in chronic lymphocytic leukemia in the era of new therapies. Curr Oncol Rep. 2022;24:1003–1014.
   PubMedGoogle Scholar