Abstract：
CLL is associated with an increased risk of infectious complications. Treatment with BTK or BCL-2 inhibitors does not seem to increase significantly the risk of opportunistic infections, but the role of combination therapies including BTK and/or BCL-2 inhibitors remains to be established. Various infectious complications can be successfully prevented with appropriate risk management strategies. In this paper we reviewed the international guidelines on prevention and management of infectious complications in patients with CLL treated with BTK or BCL-2 inhibitors. Universal pharmacological anti-herpes, antibacterial or antifungal prophylaxis is not warranted. Reactivation of HBV should be prevented in HBsAg-positive subjects. For HBsAg-negative/HBcAb-positive patients recommendations differ, but in case of combination treatment should follow those for other, particularly anti-CD20, agent. Immunization should be provided preferably before the onset of treatment. Immunoglobulin therapy has favourable impact on morbidity but not mortality in patients with hypogammaglobulinemia and severe or recurrent infections. Lack of high-quality data and heterogeneity of patients or protocols included in the studies might explain differences among the main guidelines. Better data collection is warranted.
摘要：
CLL与感染并发症的风险增加有关。BTK或BCL-2抑制剂治疗似乎不会显着增加机会性感染的风险，但包括BTK和/或BCL-2抑制剂在内的联合治疗的作用仍有待确定.通过适当的风险管理策略可以成功预防各种感染性并发症。在本文中，我们回顾了关于BTK或BCL-2抑制剂治疗CLL患者感染并发症预防和管理的国际指南。通用药理学抗疱疹，抗菌或抗真菌预防是没有必要的。在HBsAg阳性受试者中应预防HBV的再激活。对于HBsAg阴性/HBcAb阳性患者的建议不同，但如果联合治疗应该遵循其他治疗，特别是抗CD20剂。免疫接种应优选在治疗开始之前提供。免疫球蛋白治疗对低丙种球蛋白血症和严重或复发性感染患者的发病率有有利影响，但对死亡率没有影响。缺乏高质量的数据以及研究中包含的患者或方案的异质性可能解释了主要指南之间的差异。更好的数据收集是必要的。
