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Disseminated Cryptococcal Disease in a Patient with Chronic Lymphocytic Leukemia on Ibrutinib

Koh Okamoto1, Laurie A Proia2, Patricia L Demarais3

  • 1Division of Infectious Diseases, John H. Stroger Jr. Hospital of Cook County, Chicago, IL, USA; Division of Infectious Diseases, Rush University Medical Center, Chicago, IL, USA.

Case Reports in Infectious Diseases
|October 6, 2016
PubMed

Insights

This study reports the first case of disseminated cryptococcal disease in a patient with chronic lymphocytic leukemia (CLL) treated with ibrutinib. This finding suggests a potential risk of cryptococcosis in CLL patients on ibrutinib therapy.

Area of Science:

  • Infectious Diseases
  • Oncology
  • Immunology

Background:

  • Cryptococcus is an environmental fungus causing disease primarily in immunocompromised individuals.
  • Chronic lymphocytic leukemia (CLL) is not typically a risk factor for cryptococcal disease.
  • Ibrutinib, a Bruton's tyrosine kinase inhibitor, is used for CLL treatment and may affect cell-mediated immunity.

Purpose of the Study:

  • To report the first case of disseminated cryptococcal disease in a patient with CLL treated with ibrutinib.
  • To highlight the potential association between ibrutinib therapy and cryptococcal infections.

Main Methods:

  • Case report of a patient with CLL.
  • Review of patient's medical history and treatment with ibrutinib.
  • Diagnosis and management of disseminated cryptococcal disease.

Main Results:

  • The study presents the first documented case of disseminated cryptococcal disease in a CLL patient receiving ibrutinib.
  • This case suggests a potential, previously unrecognized risk associated with ibrutinib treatment.

Conclusions:

  • Disseminated cryptococcal disease should be considered in CLL patients treated with ibrutinib who present with signs of infection.
  • Early recognition and treatment of cryptococcosis are crucial in this patient population to prevent life-threatening outcomes.

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