Pneumocystis jiroveci pneumonia in relation to CD4+ lymphocyte count in patients with B-cell non-Hodgkin lymphoma treated with chemotherapy

Leuk Lymphoma. 2010 Oct;51(10):1816-21. doi: 10.3109/10428194.2010.506569.

Abstract

An increasing incidence of Pneumocystis jiroveci pneumonia (PCP) in patients with B-cell non-Hodgkin lymphoma (B-NHL) receiving rituximab treatment has been reported. We reviewed patients with B-NHL who underwent chemotherapy from 2004 to 2008 at our institution to identify risk factors for PCP development during and after chemotherapy. Among 297 patients with B-NHL, six developed PCP. Of 121 patients (41%) who received PCP prophylaxis with sulfamethoxazole–trimethoprim during chemotherapy, none developed PCP (0%), while among 176 patients (59%) who had no prophylaxis, six (3.4%) developed PCP at a median of 2 months (range: 1–3 months) after starting chemotherapy. Patients with CD4+ lymphocyte counts ≤200/mm3 before chemotherapy had a higher risk of developing PCP (p=0.045), while a history of rituximab treatment was not related to PCP. CD4+ lymphocyte counts ≤200/mm3 during and after chemotherapy were observed in 18.9% of patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Antibodies, Monoclonal, Murine-Derived / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • CD4 Lymphocyte Count
  • CD4-CD8 Ratio
  • Drug Therapy, Combination
  • Female
  • Humans
  • Lymphoma, B-Cell / complications
  • Lymphoma, B-Cell / drug therapy*
  • Male
  • Middle Aged
  • Pneumocystis carinii / drug effects*
  • Pneumonia, Pneumocystis / complications
  • Pneumonia, Pneumocystis / diagnosis
  • Pneumonia, Pneumocystis / prevention & control*
  • Risk Assessment
  • Risk Factors
  • Rituximab
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use*
  • Young Adult

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Rituximab
  • Trimethoprim, Sulfamethoxazole Drug Combination