title: Immunosuppression associated with novel chemotherapy agents and monoclonal antibodies.
abstract: The introduction of novel agents to the therapeutic armamentarium for oncologic, rheumatologic, and neurologic disorders has resulted in major clinical advances. These agents impact immune function, resulting in a discrete spectrum of infectious complications. Purine analogues and alemtuzumab alter cell-mediated immunity, resulting in opportunistic viral/fungal infections. Herpes zoster incidence increases with bortezomib. Hepatitis B reactivation may occur with rituximab. Cases of progressive multifocal leukoencephalopathy have occurred following monoclonal antibody therapy. Tumor necrosis factor-α inhibitor therapy is complicated by tuberculosis reactivation and fungal infections. We summarize the impact of these therapies on pathogenesis and spectrum of infection complicating their usage.
authors.affiliation: Hematology, Oncology and Infectious Diseases, University of Minnesota/Minneapolis VAMC.
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Morrison
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001424:Bacterial Infections / Q000276:immunology / Q000382:microbiology; D001897:Boronic Acids / Q000009:adverse effects; D000069286:Bortezomib; D005260:Female; D006801:Humans; D007108:Immune Tolerance; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000276:immunology / Q000382:microbiology; D009369:Neoplasms / Q000150:complications*; D009894:Opportunistic Infections / Q000276:immunology*; D011719:Pyrazines / Q000009:adverse effects; D014409:Tumor Necrosis Factor-alpha / Q000009:adverse effects / Q000037:antagonists & inhibitors; D014777:Virus Diseases / Q000276:immunology / Q000821:virology
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D014409:Tumor Necrosis Factor-alpha; D000069286:Bortezomib
keywords: alemtuzumab; bortezomib; fludarabine; hepatitis B; tumor necrosis factor-α inhibitors