Breakthrough Invasive Fungal Infection After Coadministration of Venetoclax and Voriconazole

Victoria G Hall; Kenny Tang; Deepali Kumar; Coleman Rotstein; Signy Chow; Steven M Chan; Shahid Husain; Seyed M Hosseini-Moghaddam

doi:10.1093/ofid/ofad134

Breakthrough Invasive Fungal Infection After Coadministration of Venetoclax and Voriconazole

Open Forum Infect Dis. 2023 Mar 16;10(3):ofad134. doi: 10.1093/ofid/ofad134. eCollection 2023 Mar.

Authors

Victoria G Hall¹, Kenny Tang², Deepali Kumar¹, Coleman Rotstein¹, Signy Chow³, Steven M Chan², Shahid Husain¹, Seyed M Hosseini-Moghaddam¹

Affiliations

¹ Transplant-Oncology Infectious Diseases, University Health Network, Toronto, Ontario, Canada.
² Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
³ Department of Hematology, Sunnybrook Health Sciences, Toronto, Ontario, Canada.

Abstract

Venetoclax requires a 75% dose reduction when coadministered with voriconazole. In a 10-year historical cohort of treatment with venetoclax, we did not observe a worse hematologic outcome in patients who received voriconazole prophylaxis versus those who did not. Subtherapeutic voriconazole levels and a triazole exposure history may contribute to breakthrough invasive fungal infection.

Keywords: breakthrough; invasive fungal infection; venetoclax; voriconazole.