Evidence map›Paper›PMID 41954633›Full record

SynthesisBlood advances2026

Invasive fungal infections after Bruton tyrosine kinase inhibitor treatment: a systematic review and meta-analysis.

Karan Srisurapanont, Tanaporn Meejun, Kasama Manothummetha, Lucy X Li, John W Baddley, Cory A Schulz, M Veronica Dioverti-Prono, Sean X Zhang, Robin K Avery, Olivia S Kates and 1 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Blood advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Karan SrisurapanontDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.ORCID 0000-0001-9296-6344
Tanaporn MeejunDepartment of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.ORCID 0000-0002-9544-7096
Kasama ManothummethaDepartment of Medicine, University of Miami, Miami, FL.ORCID 0000-0002-2446-143X
Lucy X LiDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.ORCID 0000-0002-5857-6227
John W BaddleyDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.ORCID 0000-0001-9111-625X
Cory A SchulzDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
M Veronica Dioverti-PronoDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.ORCID 0000-0002-5326-9551
Sean X ZhangDepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.ORCID 0000-0003-1166-2563
Robin K AveryDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.ORCID 0000-0001-7692-3619
Olivia S KatesDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.ORCID 0000-0003-4381-0049
Nitipong PermpalungDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.ORCID 0000-0002-0749-7342

Funding

Impact of Spatial and Social Determinants on Invasive Fungal Infection RiskK08AI193077 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Lucy Li · 2025 to 2026
$395k
NIAID NIH HHS K08 AI193077
6 · The paper itself

Abstract

abstractThe epidemiology of invasive fungal infections (IFIs) among patients receiving Bruton tyrosine kinase inhibitors (BTKIs) remains incompletely characterized. We conducted a systematic review and meta-analysis of 88 studies including 23 737 patients to evaluate the prevalence and risk factors for IFIs in this population. Among 16 studies that applied the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium consensus definitions of IFIs, the pooled prevalence of proven/probable IFIs was 2.83% (95% confidence interval [CI], 1.97-4.06), with the highest prevalence observed in patients with central nervous system lymphoma (9.02%). Aspergillosis was the most frequently reported IFI (1.76%), followed by pneumocystosis, candidiasis, and cryptococcosis. The risk factors significantly associated with proven/probable IFIs were concurrent corticosteroid use (odds ratio [OR], 5.03; 95% CI, 2.31-10.92) and ≥3 previous lines of therapy (OR, 3.26; 95% CI, 1.54-6.88). Across clinical trials, the prevalence of fungal infections varied across BTKI agents, ranging from 2.50% with tirabrutinib, to 0.62% with pirtobrutinib. Data on antifungal and Pneumocystis jirovecii pneumonia prophylaxis were limited and inconclusive. Among clinical trials that reported fungal infections as adverse events, the prevalence of IFI was the highest in patients treated with tirabrutinib (2.50%), followed by zanubrutinib (2.13%), ibrutinib (1.75%), acalabrutinib (1.31%), orelabrutinib (1.08%), and pirtobrutinib (0.62%). Although some findings suggest a potential benefit in selected patients, current evidence remains insufficient to support broad prophylaxis recommendations. These results underscore the need for individualized risk assessment and further research to inform prevention strategies.

Indexed as

Agammaglobulinaemia Tyrosine KinaseInvasive Fungal InfectionsProtein Kinase InhibitorsHumansPrevalencePyrimidinesRisk FactorsAgammaglobulinaemia Tyrosine KinaseBTK protein, humanProtein Kinase InhibitorsPyrimidines

Identifiers

PMID41954633
PMCPMC13263698

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.