Severe infections requiring intensive care unit admission in patients receiving ibrutinib for hematological malignancies: a groupe de recherche respiratoire en réanimation onco-hématologique (GRRR-OH) study
Authors' conclusion
In ibrutinib-treated patients, severe infections requiring ICU admission were associated with a dismal prognosis, mostly impacted by initial organ failures.
Study context
- Population
- Patients receiving ibrutinib for hematological malignancies admitted to ICU for severe infections, 10 French ICUs, 2015–2020matched cohort
- Participants
- 69 vs 63
- Exposure
- Ibrutinib vs Controls
- Ibrutinibn = 69
- Controlsn = 63reference
- Outcome
- Features and outcomes of severe infections (ibrutinib cohort)
Methodological details10 French ICUs, matched historic control cohort
- 10 French ICUs
- Matched historic control cohort
Main finding
As reported in the abstract
- Median time from ibrutinib initiation (months)
- 6.6 [3-18]
- Invasive fungal infections
- 19% (n = 13/69)
- Invasive aspergillosis among invasive fungal infections (IFI)
- 9 (69%; n = 9/13)
- Pneumocystis pneumonia among IFI
- 3 (23%; n = 3/13)
- Cryptococcosis among IFI
- 1 (8%; n = 1/13)
- Acute respiratory failure
- 71%; n = 49/69
- Mechanical ventilation
- 41% (n = 28/69)
- ICU mortality
- 20 (29%; n = 20/69)
- Day-90 mortality
- 55% (n = 35/64)
Observational data: associations, not effects.
Further findings
Fungal infections (matched cohort) · matched cohort
P = 0.001
Viral infections (matched cohort) · matched cohort
P = 0.027
ICU mortality (matched cohort) · matched cohort
P = 0.254
Day-90 mortality (matched cohort) · matched cohort
P = 0.785
Median
| Outcome | Ibrutinib | Controls | P value |
|---|---|---|---|
| SOFA score, decedents vs survivors | P = 0.004 | ||
| Mechanical ventilation, decedents vs survivors | P = 0.010 | ||
| Prior chemotherapy lines (matched cohort)Matched cohort | 2 (range 1–2) | 0 (range 0–2) | P < 0.001 |
- SOFA score, decedents vs survivors: Decedents 7 (range 5–11)
- SOFA score, decedents vs survivors: Survivors 4 (range 3–7)
- Mechanical ventilation, decedents vs survivors: Decedents 68%
- Mechanical ventilation, decedents vs survivors: Survivors 31%
Original publication
Severe infections requiring intensive care unit admission in patients receiving ibrutinib for hematological malignancies: a groupe de recherche respiratoire en réanimation onco-hématologique (GRRR-OH) study. Ann Intensive Care. Published 6 December 2023. doi:10.
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