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.