Table 2 Literature review for reported cases of cryptococcal infection in patients receiving ruxolitinib
Author [Year] | Patient | Gender/Age | Clinical diagnosis | Underlying disease(s) | Ruxolitinib duration | Symptoms | Laboratory findings | Imaging | Organism/site | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|
Wysham N, et al. [2013] [4] | 1 | Male/66 | Pneumonia | Polycythemia vera and myelofibrosis | 18 months | Dyspnea, cough, and intermittent fever | - Mild leukocytosis - Serum cryptococcal Ag 1:4 | Multifocal consolidations with surrounding ground glass opacities | Cryptococcus neoformans (BAL) | - Oral fluconazole (5 months) - Discontinue ruxolitinib | Survived |
Chen C, et al. [2016] [10] | 2 | Female/69 | Meningoencephalitis | Myelofibrosis | 46 months | Fever, alteration of consciousness | - Blood chemistry: NA - CSF cryptococcal Ag 1:512 | Normal brain imaging | - Cryptococcus neoformans (Fungal CSF culture) | - Amphotericin B and high-dose fluconazole | Survived |
Hirano A, et al. [2017] [5] | 3 | Male/79 | Pulmonary nodules | Primary myelofibrosis | 6 months | Asymptomatic | - Normal CBC - Serum cryptococcal Ag 1:8 | Multiple pulmonary nodules | Cryptococcus spp. (TBBx) | - Oral voriconazole (5 months) - Discontinue ruxolitinib | Survived |
Liu J, et al. [2018] [9] | 4 | Male/71 | Pericardial effusion | Chronic myelomonocytic leukemia | NA | Cardiac tamponade | - Marked leukocytosis - AKI, metabolic acidosis, liver dysfunction | Bilateral pulmonary infiltrations (CXR) | Cryptococcus neoformans (Blood and pericardial culture) | - IV micafungin - IV fluconazole | Died |
Prakash K and Richman D [2019] [6] | 5 | Male/51 | Meningitis | Polycythemia vera | 18 months | Fever, lethargy, headache, weight loss, oral ulcer | - AKI, hyponatremia, elevated ALP - CSF pleocytosis - Serum cryptococcal Ag 1:128 | - Innumerable rim enhancing lesions at the gray-white junction - Retrocardiac mass | - Cryptococcus neoformans (Fungal CSF culture) - Histoplasma capsulatum | - Amphotericin B and flucytosine - Isavuconazole - Discontinue ruxolitinib | Survived |
Tsukui D, et al. [2020] [11] | 6 | Male/76 | Meningitis | Myelofibrosis | 5 months | Fever, alteration of consciousness | - Anemia with normal WBC and platelet - CSF pleocytosis - Serum cryptococcal Ag positive (qualitative) | Normal brain imaging | - Cryptococcus neoformans (CSF- quantitative assay titers positive 1:16) | - Amphotericin B 37 days, then oral fluconazole - Discontinue ruxolitinib | Survived |