Invasive fungal infections in paediatric patients treated with macromolecular immunomodulators other than tumour necrosis alpha inhibitors

Mycoses. 2017 Aug;60(8):493-507. doi: 10.1111/myc.12621. Epub 2017 Apr 26.

Abstract

An expanding list of immunomodulatory or immunosuppressive monoclonal antibodies (mAbs) and biologic therapeutics is currently entering clinical practice, particularly in the areas of oncology, transplantation and autoimmune disorders. These agents are directed against molecules or cells involved in inflammation and immunity and may therefore be associated with serious and opportunistic infections. The purpose of this review was to critically analyse the literature on invasive fungal infections (IFIs) occurring in association with mAbs and fusion proteins other than tumour necrosis alpha (TNF-α) inhibitors, including therapeutics modulating T-cell-mediated pathologies (muromonab, abatacept, belatacept, ipilimumab, basiliximab, daclizumab), inducing lymphopenia (alemtuzumab), depleting CD20+ B cells (rituximab) and interfering with various targets (anakinra, natalizumab, blodalumab, ixekizumab and others) with a focus on children, and to provide a framework of evaluating the risk for IFIs in this population.

Keywords: Pneumocystis; alemtuzumab; basiliximab; daclizumab; monoclonal antibodies; rituximab.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / classification
  • Antibodies, Monoclonal / therapeutic use*
  • Child
  • Humans
  • Immunologic Factors / therapeutic use*
  • Invasive Fungal Infections / drug therapy*

Substances

  • Antibodies, Monoclonal
  • Immunologic Factors