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Prophylaxis of Pneumocystis carinii pneumonia with atovaquone in children with leukemia
Author(s) -
Madden Renee M.,
Pui ChingHon,
Hughes Walter T.,
Flynn Patricia M.,
Leung Wing
Publication year - 2007
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.22562
Subject(s) - pneumocystis carinii , medicine , atovaquone , pneumonia , leukemia , virology , immunology , pneumocystis jirovecii , malaria , plasmodium falciparum
BACKGROUND. Despite extensive studies of atovaquone in human immunodeficiency virus (HIV)‐infected patients, there is little information about its efficacy as a prophylactic agent for Pneumocystis carinii pneumonia (PCP) in pediatric patients with cancer. Therefore, a retrospective analysis was conducted to determine the incidence of PCP in pediatric patients who received prophylactic atovaquone during treatment for acute leukemia. METHODS. We reviewed the medical records of all patients treated at our institution for acute lymphoblastic leukemia or acute myeloid leukemia between 1994 and 2004. Only patients who were intolerant of trimethoprim‐sulfamethoxazole (TMP‐SMZ) and received atovaquone prophylaxis were included in the analysis. RESULTS. Eighty‐six patients were unable to tolerate TMP‐SMZ and received daily atovaquone for PCP prophylaxis. PCP was not diagnosed in any patient who received atovaquone prophylaxis: the upper limit of the 95% confidence interval (CI) was 1.74 per 100 person‐years. CONCLUSIONS. Atovaquone is an efficacious alternative for PCP prophylaxis in pediatric patients who have leukemia and are intolerant of TMP‐SMZ. Cancer 2007. © 2007 American Cancer Society.