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 or myeloid cells surface antigens [II]: CD22, CD30, CD33, CD38, CD40, SLAMF-7 and CCR4)

  • Clin Microbiol Infect. 2018 Jun;24 Suppl 2:S83-S94. doi: 10.1016/j.cmi.2018.03.022.
L Drgona  1 ,  C Gudiol  2 ,  S Lanini  3 ,  B Salzberger  4 ,  G Ippolito  3 ,  M Mikulska  5
Affiliations
  • 1. Department of Oncohematology, Comenius University and National Cancer Institute, Bratislava, Slovakia.
  • 2. Department of Infectious Diseases, University Hospital of Bellvitge, IDIBELL, Barcelona, Spain.
  • 3. Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases "Lazzaro Spallanzani", Rome, Italy.
  • 4. Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany.
  • 5. Division of Infectious Diseases, University of Genoa and Ospedale Policlinico San Martino, Genova, Italy. Electronic address: [email protected].
PMID: 29572070 DOI: 10.1016/j.cmi.2018.03.022
Abstract

Background: The present review is part of the ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies.

Aims: To review, from an Infectious Diseases perspective, the safety profile of agents targeting CD22, CD30, CD33, CD38, CD40, SLAMF-7 and CCR4 and to suggest preventive recommendations.

Sources: Computer-based MEDLINE searches with MeSH terms pertaining to each agent or therapeutic family.

Content: The risk and spectrum of infections in patients receiving CD22-targeted agents (i.e. inotuzumab ozogamicin) are similar to those observed with anti-CD20 antibodies. Anti-Pneumocystis prophylaxis and monitoring for cytomegalovirus (CMV) Infection is recommended for patients receiving CD30-targeted agents (brentuximab vedotin). Due to the scarcity of data, the risk posed by CD33-targeted agents (gemtuzumab ozogamicin) cannot be assessed. Patients receiving CD38-targeted agents (i.e. daratumumab) face an increased risk of varicella-zoster virus (VZV) Infection. Therapy with CD40-targeted agents (lucatumumab or dacetuzumab) is associated with opportunistic infections similar to those observed in hyper-IgM syndrome, and prevention strategies (including anti-Pneumocystis prophylaxis and pre-emptive therapy for CMV Infection) are warranted. SLAMF-7 (CD319)-targeted agents (elotuzumab) induce lymphopenia and increase the risk of Infection (particularly due to VZV). The impact of CCR4-targeted agents (mogamulizumab) on Infection susceptibility is difficult to distinguish from the effect of underlying diseases and concomitant therapies. However, anti-Pneumocystis and anti-herpesvirus prophylaxis and screening for chronic hepatitis B virus (HBV) Infection are recommended.

Implications: Specific management strategies should be put in place to reduce the risk and/or the severity of infectious complications associated to the reviewed agents.

Keywords
Brentuximab vedotin; Daratumumab; Gemtuzumab ozogamicin; Infection; Inotuzumab ozogamicin; Lucatumumab; Mogamulizumab; Moxetumomab pasudotox.
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