Determining the incidence of serious infections and evaluation of the risk factors in patients with hematological malignancies treated with tyrosine kinase inhibitors

The aims of this study are; to determine the frequency of serious infections in patients with hematological malignancies treated with Tyrosine Kinase Inhibitors (TKI), to define the distribution of infections and pathogen microorganisms causing the infection and to evaluate the risk factors affecting the development of the serious infections. The study was conducted as a single-center, retrospective and descriptive study, by evaluating the medical records of the patients between 2014-2021. Serious infections in these patients were recorded. The risk factors for the development of infections were evaluated by comparing the patients with and without the infections by using univariate and multivariate analysis. A total of 300 patients were included in the study. The incidence of serious infections was found to be 32.3%. In 97 patients who developed infections, 327 episodes of infections were identified. The mean time to develop the first serious infection was 122 days. The most common serious infection was found to be pneumonia. The incidence of invasive fungal infections was found to be 5.8%. Invasive fungal infections were most common in patients who were treated with ibrutinib and venetoclax, whereas other opportunistic infections were most common in patients treated with ruxolitinib. Diabetes Mellitus, Chronic Kidney Disease, COPD/Asthma, Chronic Lymphocytic Leukemia (CLL), Allogeneic Stem Cell Transplantation, Neutropenia, chemotherapy treatment before TKI, combined with TKI especially Ibrutinib, were defined as risk factors for development of serious infections. Chronic Myeloid Leukemia (CML) and imatinib were found to be protective against the development of serious infections. As a result; It has been determined that patients with hematological malignancies who had comorbidities, were treated with ibrutinib, used chemotherapy together with TKI and those thus used chemotherapy before TKI, were at higher risk for the development of serious infections, especially within the first year treatment of TKI. Therefore, it was thought that these patients should be followed closely for the development of serious infections. Keywords; Tyrosine Kinase Inhibitors (TKI), Ibrutinib, Serious İnfections, Risk Factors