Acanthamoeba Encephalitis in Chronic Lymphocytic Leukemia: Case Report Highlights Infection Risk with Ibrutinib
核心洞察
A case report describes granulomatous amebic encephalitis (搜索) (GAE) caused by Acanthamoeba (搜索) in a patient with chronic lymphocytic leukemia (搜索) (CLL) managed with ibrutinib.
Acanthamoeba (搜索) is a free-living amoeba transmitted via inhalation or direct contact with the eyes or skin, capable of causing keratitis and GAE.
GAE occurs most often in immunocompromised patients, with risk factors including hematologic malignancy and immunosuppressive drugs.
A case report and retrospective review published by the Centers for Disease Control and Prevention (搜索) (CDC) describes granulomatous amebic encephalitis (搜索) (GAE) caused by Acanthamoeba (搜索) in a patient with chronic lymphocytic leukemia (搜索) (CLL) managed with ibrutinib. The report highlights the infectious complications associated with immunomodulatory therapy in hematologic malignancy and examines the frequency of Acanthamoeba infections among patients with CLL.
Acanthamoeba (搜索) is a free-living amoeba (FLA) transmitted via inhalation or direct contact with the eyes or skin that can cause keratitis and granulomatous amebic encephalitis (搜索) (GAE). GAE occurs most often in immunocompromised patients, with risk factors including hematologic malignancy and immunosuppressive drugs.
Chronic lymphocytic leukemia (搜索) (CLL), the most common leukemia, can lead to immune dysfunction from immunosuppressive treatments and hypogammaglobulinemia, as well as impairments in complement activity, cell-mediated immunity, and neutrophil function. The 5-year risk for severe infections in CLL is as high as 57% when IgG levels are low.
Ibrutinib, a Bruton tyrosine-kinase inhibitor, is an immunomodulatory drug used for CLL treatment that increases the risk for invasive infections up to 11.4% during the first year of treatment through innate immune system impairment.
Using a retrospective analysis of data from the CDC Free-Living Ameba database, the authors sought to determine the frequency of Acanthamoeba (搜索) infections among patients with CLL and to compare clinical characteristics with those of patients without CLL.
The report was authored by Dr. Persico, a fourth-year neurology resident at Emory University School of Medicine and part of the editorial board for the journal Neurology: Resident and Fellow Section. His primary research interests include drug discovery and targeted therapies in neuro-oncology and complications of cancer and cancer therapies.