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Pneumocystis jirovecii pneumonia in diffuse large B‐cell Lymphoma treated with R‐CHOP
Author(s) -
Lee Ji Yun,
Kang Minsu,
Suh Koung Jin,
Kim JiWon,
Kim Se Hyun,
Kim Jin Won,
Kim Yu Jung,
Song KyoungHo,
Kim Eu Suk,
Kim Hong Bin,
Lee KeunWook,
Kim Jee Hyun,
Bang SooMee,
Lee JongSeok,
Lee JeongOk
Publication year - 2021
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.13184
Subject(s) - medicine , vincristine , international prognostic index , rituximab , incidence (geometry) , prednisone , lymphoma , diffuse large b cell lymphoma , gastroenterology , pneumocystis pneumonia , cyclophosphamide , chop , pneumocystis jirovecii , surgery , pneumonia , chemotherapy , physics , optics
Background The aim of this study was to estimate the incidence of and risk factors for Pneumocystis pneumonia (PCP) infection in diffuse large B‐cell lymphoma (DLBCL) patients treated with rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R‐CHOP). Methods The medical records of 739 DLBCL patients who received R‐CHOP between May 2004 and January 2019 were retrospectively evaluated. Patients were divided into two groups: those who received primary PCP prophylaxis (prophylaxis group) and those who did not (control group). The incidence rate of PCP in each group was calculated, and risk factors for PCP were evaluated in the control group. Results Baseline characteristics were significantly different between the two groups. Compared to the 602 patients who did not receive prophylaxis, the prophylaxis group (n = 137) had poor prognostic factors of older age, high lactate dehydrogenase (LDH) levels, advanced Ann Arbour stage, and high International Prognostic Index (IPI) risk scores. None of the patients receiving PCP prophylaxis developed PCP, while the incidence of PCP in the control group was 8.1% (definite cases 5.5% and probable cases 2.7%). Out of the 49 patients who developed PCP, 10 patients (20.4%) were admitted to the intensive care unit, and the PCP‐related death rate was 16.3% (8/49). Conclusion This study showed that PCP prophylaxis is highly effective against PCP infection and may help guide prevention of PCP during R‐CHOP treatment in DLBCL patients.