Topics:
Hematologic Malignancies • Medical Oncology • Leukemia • CLL • Hematology • Infectious Disease
Do you routinely offer fungal prophylaxis for patients on BTK inhibitors?
Can experts comment on fungal pneumonia risk with individual BTK inhibitors as seen in ELEVATE-RR and whether this impacts their management decisions?
Answer from: Medical Oncologist at Academic Institution
We do not use antifungal prophylaxis for patients on BTK inhibitors. The risk of invasive fungal infection in patients treated with BTK inhibitors in recent large single institutional series have been 2 to 3%, without routine antifungal prophylaxis. The risk of fungal infection increases in patients...
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Answer from: Medical Oncologist at Academic Institution
I do not routinely prophylaxis for fungal infections with BTK inhibitors. While fungal infections, specifically aspergillus is a risk, it is still relatively rare. As well, antifungal medications often interact with BTKi.
Answer from: Medical Oncologist at Academic Institution
I never use fungal prophylaxis with BTKi unless patients are on steroids. Here the risk is higher and I would consider this. There was not an increased risk of fungal pneumonia in the ELEVATE-RR over what would be expected in the CLL patient population.