The Bruton tyrosine kinase (BTK) inhibitor ibrutinib is increasingly used in the treatment of chronic lymphocytic leukemia (CLL). Moreover, very promising results have been reported in other B-cell malignancies, including primary central nervous system lymphoma (PCNSL). Although well-tolerated in the majority of patients, ibrutinib demonstrates in some cases troublesome toxicities, including invasive fungal infections (IFIs). In the present review, we summarize clinical manifestations of IFIs in patients treated with ibrutinib, generally characterized by an early onset, mild clinical manifestations, asymptomatic/low symptomatic pulmonary localization and high incidence of central nervous system (CNS) involvement. IFI risk appears particularly increased in patients receiving ibrutinib associated with other immune modulator agents, especially with steroids or immune-chemotherapy. Moreover, the immunomodulatory effect of ibrutinib is described, pointing the attention on the involvement of specific molecules targeted by ibrutinib in innate and adaptive response to fungal infection. Overall, the findings indicate the ibrutinib may rapidly impair innate immune cell functions, while concomitantly restoring an effective protective potential of adaptive immune compartment. A correct awareness, especially when other predisposing factors are present, is warranted about the potential risk of IFIs in ibrutinib-treated patients.

布鲁顿酪氨酸激酶（BTK）抑制剂依鲁替尼（ibrutinib）越来越多地用于治疗慢性淋巴细胞性白血病（CLL）。此外，在其他B细胞恶性肿瘤，包括原发性中枢神经系统淋巴瘤（PCNSL）中，已经报道了非常有希望的结果。尽管在大多数患者中耐受性良好，但依鲁替尼在某些情况下显示出令人讨厌的毒性，包括侵入性真菌感染（IFI）。在本综述中，我们总结了接受依鲁替尼治疗的患者中IFI的临床表现，其特征通常是早期发作，轻度临床表现，无症状/低症状性肺部定位以及中枢神经系统（CNS）受累的高发生率。在接受ibrutinib与其他免疫调节剂相关联的患者中，IFI风险似乎特别增加，特别是使用类固醇或免疫化学疗法时。此外，描述了依鲁替尼的免疫调节作用，将注意力集中在依鲁替尼靶向的特定分子参与对真菌感染的先天性和适应性反应中。总的来说，研究结果表明，依鲁替尼可能会迅速损害先天免疫细胞的功能，同时恢复适应性免疫区室的有效保护潜力。对于使用依鲁替尼治疗的患者存在IFI的潜在风险，尤其是在存在其他诱发因素的情况下，有必要提供正确的认识。这些发现表明，依鲁替尼可能会迅速损害先天免疫细胞的功能，同时恢复适应性免疫区室的有效保护潜力。对于使用依鲁替尼治疗的患者存在IFI的潜在风险，尤其是在存在其他诱发因素的情况下，有必要提供正确的认识。这些发现表明，依鲁替尼可能会迅速损害先天免疫细胞的功能，同时恢复适应性免疫区室的有效保护潜力。对于使用依鲁替尼治疗的患者存在IFI的潜在风险，尤其是在存在其他诱发因素的情况下，有必要提供正确的认识。