{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:48:10Z","timestamp":1791488890942,"version":"4.3.4"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T00:00:00Z","timestamp":1709078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Prior reports have suggested a possible increase in the frequency of invasive fungal infections (IFIs) with use of a Bruton tyrosine kinase inhibitor (BTKi) for treatment of chronic lymphoid malignancies such as chronic lymphocytic leukemia (CLL), but precise estimates are lacking. We aim to characterize the prevalence of IFIs among patients with CLL, for whom a BTKi is now the first-line recommended therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We queried TriNetX, a global research network database, to identify adult patients with CLL using the International Classification of Diseases, Tenth Revision code (C91.1) and laboratory results. We performed a case-control propensity score\u2013matched analysis to determine IFIs events by BTKi use. We adjusted for age, sex, ethnicity, and clinical risk factors associated with an increased risk of IFIs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 5358 matched patients with CLL, we found an incidence of 4.6% of IFIs in patients on a BTKi versus 3.5% among patients not on a BTKi at 5 years. Approximately 1% of patients with CLL developed an IFI while on a BTKi within this period. Our adjusted IFI event analysis found an elevated rate of Pneumocystis jirovecii pneumonia (PJP) (0.5% vs 0.3%, P = .02) and invasive candidiasis (3.5% vs 2.7%, P = .012) with the use of a BTKi. The number needed to harm for patients taking a BTKi was 120 and 358 for invasive candidiasis and PJP, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We found an adjusted elevated rate of PJP and invasive candidiasis with BTKi use. The rates are, however, low with a high number needed to harm. Additional studies stratifying other IFIs with specific BTKis are required to identify at-risk patients and preventive, cost-effective interventions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofae115","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T02:08:38Z","timestamp":1709172518000},"source":"Crossref","is-referenced-by-count":15,"title":["Risk of Invasive Fungal Infections in Patients With Chronic Lymphocytic Leukemia Treated With Bruton Tyrosine Kinase Inhibitors: A Case-Control Propensity Score\u2013Matched Analysis"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9363-6280","authenticated-orcid":false,"given":"Nelson Iv\u00e1n","family":"Agudelo Higuita","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma , USA"},{"name":"Instituto de Enfermedades Infecciosas y Parasitolog\u00eda Antonio Vidal , Tegucigalpa , Honduras"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4018-0195","authenticated-orcid":false,"given":"Daniel B","family":"Chastain","sequence":"additional","affiliation":[{"name":"Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy , Albany, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Scott","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syeda","family":"Sahra","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian","family":"Vargas Barahona","sequence":"additional","affiliation":[{"name":"Department of Medicine, Creighton University School of Medicine , Omaha, Nebraska , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Henao Cordero","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred L H","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Prince of Wales Hospital , Hong Kong Special Administration Region , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Tuells","sequence":"additional","affiliation":[{"name":"Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, San Vicente del Raspeig , Alicante , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7363-8652","authenticated-orcid":false,"given":"Andr\u00e9s F","family":"Henao-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Colorado Anschutz Medical Campus , Aurora, Colorado , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"key":"2024061711515622700_ofae115-B1","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1001\/jama.2023.1946","article-title":"Diagnosis and treatment of chronic lymphocytic leukemia: a review","volume":"329","author":"Shadman","year":"2023","journal-title":"JAMA"},{"key":"2024061711515622700_ofae115-B2","article-title":"Risk of infection associated with targeted therapies for solid organ and hematological malignancies","volume":"8","author":"Ruiz-Camps","year":"2021","journal-title":"Ther Adv Infect 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