Current therapies for chronic lymphocytic leukemia: risk and prophylaxis strategies for secondary/opportunistic infections

Introduction: Currently, the implementation of new therapeutic options for treatment of chronic lymphocytic leukemia (CLL) considerably improved the outcome of this disease. However, patients affected by CLL are at higher risk for infections, due to the state of immunosuppression related to hematologic disease and therapies. Consequently, anti-infective prophylaxis should be properly managed, according to risk factors for opportunistic infection, related to antineoplastic drugs and characteristics of patients.Areas covered: This review aims to summarize current knowledge on secondary/opportunistic infections during CLL treatment, including chemo-immunotherapies, Bruton Tyrosine Kinase inhibitors, idelalisib and venetoclax. In addition, possible schemes of prophylaxis are provided.Expert opinion: The establishment of a multidisciplinary team including hematologist and infectious diseases specialist is pivotal for the best management of anti-infective prophylaxis and prevention of new onset infections.