Infectious Complications Associated With Immunomodulating Monoclonal Antibodies Used in the Treatment of Hematologic Malignancy

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  • a From Brigham & Women's Hospital and Harvard Medical School and Dana-Farber Cancer Institute, Boston, Massachusetts.

Immunomodulating monoclonal antibodies are a relatively new addition to the armamentarium of cancer therapeutics and have been shown to improve clinical outcomes in patients with various hematologic malignancies. Because of their targeted nature, these agents are often believed to be less immunosuppressive than standard cytotoxic chemotherapeutic agents. A clear causal association between an immunomodulating therapy and its infectious sequelae is often difficult to discern because of the burden of comorbid illness, intrinsic immunosuppression from the underlying malignancy, use in the salvage setting, and prior and concomitant use of immunosuppressive agents in this patient population. This article evaluates better-established and anecdotal infectious complications associated with major immunomodulating therapies used in hematologic malignancy and hematopoietic stem cell transplantation, including rituximab, alemtuzumab, gemtuzumab ozogamicin, infliximab, dacluzimab, and basiliximab.

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Correspondence: Sophia Koo, MD, Division of Infectious Diseases, Brigham & Women's Hospital, 15 Francis Street, PBB-A4, Boston, MA 02115. E-mail: skoo@partners.org

EDITORS

Brahm Segal, MD, Chief of the Infectious Disease Department, Roswell Park Cancer Institute, Buffalo, New York; Co-Chair, NCCN Prevention and Treatment of Cancer-Related Infections Panel

Disclosure: Brahm Segal, MD, has disclosed that he has served on the speaker's bureau for Merck and Pfizer and has served on the advisory board for Pfizer.

Alison G. Freifeld, MD, Director, Immunocompromised Host Infectious Diseases Program, Professor of Medicine, UNMC Eppley Cancer Center, The Nebraska Medical Center, Omaha, Nebraska

Disclosure: Alison G. Freifeld, MD, has disclosed that she has accepted financial support in the form of research support, advisory committee membership, or speaker's bureau participation from Genzyme Pharmaceuticals, Schering-Plough Corporation, Enzon Pharmaceuticals, and Astellas Pharma, Inc.

CME AUTHOR

Désirée Lie, MD, MSEd, Clinical Professor, Family Medicine, University of California, Orange; Director, Division of Faculty Development, UCI Medical Center, Orange, California

Disclosure: Désirée Lie, MD, MSEd, has disclosed no relevant financial relationships.

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