慢性淋巴细胞白血病中的感染:不断变化的风险和预防策略
Enrica Antonia Martino1, Santino Caserta1, Ernesto Vigna1
1Hematology Unit, Department of Onco-Hematology, AO of Cosenza, Cosenza, Italy.
European journal of haematology
|November 26, 2025
概括
感染是慢性淋巴细胞白血病 (CLL) 患者的主要威胁,原因是免疫功能障碍和新疗法风险. 个性化预防策略,包括预防和疫苗接种,对于管理CLL感染风险至关重要.
科学领域:
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 感染是慢性淋巴细胞白血病 (CLL) 患者的主要死亡原因.
- 在CLL中的免疫功能障碍涉及B细胞,T细胞,中性粒细胞和NK细胞.
- 新型向疗法 (BTKis,venetoclax,抗CD20) 改变了感染风险.
研究的目的:
- 审查CLL中不断变化的感染风险景观.
- 讨论当前和未来的预防策略.
- 强调个性化,与风险相适应的预防方法.
主要方法:
- 关于CLL感染风险和管理的文献综述.
- 分析新型向治疗对感染并发症的影响.
- 综合目前的预防性指导方针和未来的研究方向.
主要成果:
- 向疗法将感染风险从机会性转移到真菌,病毒和细菌.
- 布鲁顿的氨酸激酶抑制剂 (BTKis) 与真菌感染和肺炎有关.
- 威尼托克拉克斯可以引起中性缺血;抗CD20抗体导致B细胞枯竭和病毒重新激活.
结论:
- 个人预防 (抗病毒,PJP) 和免疫球蛋白替代是必不可少的.
- 疫苗接种,虽然往往不理想,仍然是关键;时间和配方是很重要的.
- 未来的研究应该集中在生物标志物,免疫监测和免疫恢复策略上.
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