A case of CNS aspergillosis in a patient with chronic lymphocytic leukemia on first-line ibrutinib therapy

Ibrutinib has revolutionized the treatment of chronic lymphoid malignancies. Despite its success, ibrutinib has been linked with several reports of invasive fungal infections. We present a case of CNS aspergillosis in a CLL patient on first line ibrutinib therapy. We summarize existing case reports and case series of invasive aspergillosis in patients on ibrutinib, the pathogenesis of invasive aspergillosis, and discuss the clinical controversies regarding anti-fungal prophylaxis in this population. Keywords: Aspergillus, Ibrutinib, Central nervous system (CNS), Chronic lymphocytic leukemia (CLL), Invasive fungal infection (IFI)