ReviewHematology. American Society of Hematology. Education Program2020
Practical approach to monitoring and prevention of infectious complications associated with systemic corticosteroids, antimetabolites, cyclosporine, and cyclophosphamide in nonmalignant hematologic diseases.
Review in Hematology. American Society of Hematology. Education Program, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Guideline
- Dupilumab Treatment Up to 5 Years Shows No Clinically Meaningful Changes in Laboratory Parameters in Adults with Moderate-to-Severe Atopic Dermatitis.Advances in therapy · 2026Trial
- Risk Factors for Secondary Immunodeficiency in the Aged.The journal of allergy and clinical immunology. In practice · 2026Review
- International travel considerations for patients with systemic autoimmune inflammatory diseases in the era of novel immunosuppressive therapies.Rheumatology international · 2026Review
- Comparison of infectious complications following early versus late pulse steroid therapy in renal transplant recipients.World journal of nephrology · 2026Article
- Are CD4Livers · 2026Article
- Infectious complications in acquired hemophilia A: insights from the Spanish registry (AHASR).Haematologica · 2026Article
- How I Treat: Infections and inborn errors of immunity-Prevention, diagnosis, and treatment.Journal of human immunity · 2026Review
- Practical recommendations for infectious prophylaxis and vaccination in multiple myeloma patients.Frontiers in medicine · 2026Review
- Management of toxicities from antibody - drug conjugates in breast cancer.Frontiers in oncology · 2026Review
- Article
- Prevalence and incidence of comorbidities in patients with atopic dermatitis, psoriasis, alopecia areata, and vitiligo using a Japanese claims database.The Journal of dermatology · 2025Article
- Toxicities and management strategies of emerging antibody-drug conjugates in breast cancer.Therapeutic advances in medical oncology · 2025Review
- Myasthenia gravis and community-acquired pneumonia: therapeutic challenges.Frontiers in pharmacology · 2025Review
- Public Health Risks of PFAS-Related Immunotoxicity Are Real.Current environmental health reports · 2024Review
- Clinical Pharmacology in Sarcoidosis: How to Use and Monitor Sarcoidosis Medications.Journal of clinical medicine · 2024Review
- Diagnosis and management of autoimmune diseases in the ICU.Intensive care medicine · 2024Review
- Navigating the Landscape of Hydrocortisone Administration in Septic Shock: Current Concepts and Future Directions.Cureus · 2023Review
- Review
- Recommendations for the Clinical Approach to Immune Thrombocytopenia: Spanish ITP Working Group (GEPTI).Journal of clinical medicine · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Corticosteroids constitute a first-line therapy for adults and children suffering from nonmalignant immune-mediated hematologic diseases. However, high disease relapse rates during the tapering period or upon drug discontinuation result in long-term corticosteroid use that increases the risk of infection. This same concept applies to other immunosuppressive agents, such as antimetabolites, calcineurin inhibitors, and cyclophosphamide. Corticosteroids are associated with a length-of-treatment and dose-dependent risk for infection. Screening and antimicrobial prophylaxis against tuberculosis, hepatitis B, Strongyloides stercoralis, and Pneumocystis jirovecii pneumonia (PJP) might be indicated in patients who are scheduled to be on high-dose corticosteroids for >4 weeks (>30 mg of prednisone-equivalent dose [PEQ]) or in patients chronically treated (≥8 weeks of continuous or intermittent corticosteroid use) with moderate doses (≥15 to <30 mg PEQ). Antimetabolites (azathioprine, mycophenolate) increase the risk of progressive multifocal leukoencephalopathy (PML); however, other opportunistic infections and viral reactivation have also been reported. In case of new onset of neurological symptoms, PML needs to be considered, and an urgent neurology consultation should be obtained. Cyclophosphamide-induced myelosuppression can lead to serious infections related to neutropenia. PJP prophylaxis should be considered with combination therapy of cyclophosphamide and corticosteroids until a PEQ dose ≤ 5 mg/d is reached. Data on infectious risk when cyclosporine is used in patients with nonmalignant hematologic diseases are lacking. Discontinuation of any immunosuppressive agent during an episode of infection is recommended. In all patients, adherence to an age-based immunization schedule is appropriate.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.