Abstract
New immunotherapies and targeted therapies require to have a good knowledge of immunity and of the regulatory pathways of hematopoiesis and oncogenesis, in order to assess infectious risks and take appropriate preventive measures. Anti-herpetic and anti-varicella-zoster prophylaxis appear to be universal for most treatments, and anti-Pneumocystis prophylaxis is to be discussed for many of them. Immunostimulation induced by check-point inhibitors may activate latent tuberculosis infection. Increased vigilance is required against fungal infections with BTK and JAK inhibitors and progressive multifocal leukoencephalopathy with anti-CD20 antibodies and brentuximab-vedotin. Cytomegalovirus infections, which are common with PI3K inhibitors and bispecific antibodies, warrant regular monitoring if CMV serology is positive. Finally, immunoglobulin supplementation, which is systematic with bispecific anti-BCMA antibodies, should be discussed in the case of recurrent and/or severe infections with anti-CD19/CD20. A dedicated vaccinology consultation is essential in the era of these new therapies.
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