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Quantification of the effect of chemotherapy and steroids on risk of P neumocystis jiroveci among hospitalized patients with adult T ‐cell leukaemia
Author(s) -
Maeda Toshiki,
Babazono Akira,
Nishi Takumi,
Matsuda Shinya,
Fushimi Kiyohide,
Fujimori Kenji
Publication year - 2015
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13154
Subject(s) - chemotherapy , medicine , retrospective cohort study , odds ratio , logistic regression , oncology
Summary This study aimed to quantify the risks of Pneumocystis pneumonia ( PCP ) among adult T‐cell leukaemia ( ATL ) patients without prophylaxis. We used hospital administrative data collected nationwide in Japan over 4 years. The research design was a retrospective cohort study. Subjects were 4369 patients diagnosed with ATL aged 18 years or older. The subjects were categorized into four treatment groups: no agent, chemotherapy, chemotherapy + steroids and steroids. We described the risks of PCP among ATL patients without prophylaxis. Risks of PCP were 3·2% for the no agent group, 9·7% for the chemotherapy group, 10·0% for the chemotherapy + steroids group and 16·6% for the steroids group. Logistic regression analyses showed that the chemotherapy, chemotherapy + steroids and steroids groups had significantly higher risk of PCP than did the no agent group [adjusted odds ratio ( AOR ) 3·30 (1·55–7·02), P = 0·002 for the chemotherapy group; AOR 3·35 (2·18–5·17), P < 0·001 for the chemotherapy + steroids group; AOR 6·12 (3·99–9·38), P < 0·001 for the steroids group]. In conclusion, the chemotherapy, chemotherapy + steroids and steroids groups had significantly higher risks of PCP . Prophylaxis for PCP among ATL patients being treated with chemotherapy, chemotherapy + steroids and steroids is highly recommended.