Incidence of Pneumocystis jirovecii pneumonia after temozolomide for CNS malignancies without prophylaxis

CNS Oncol. 2014 Jul;3(4):267-73. doi: 10.2217/cns.14.24.

Abstract

Aims: Prophylaxis against Pneumocystis jiroveci pneumonia (PJP) is currently recommended for patients receiving chemoradiation with temozolomide for newly diagnosed glioblastoma multiforme. At our institution, PJP prophylaxis during temozolomide treatment has not been routinely given because of the paucity of supporting data. We investigated the rate of PJP infections in our patients.

Patients & methods: We conducted a retrospective chart review of 240 brain tumor patients treated between 1999 and 2012 with temozolomide and no PJP prophylaxis, 127 of which received concurrent chemoradiation.

Results: One in 240 patients (0.4%; 95% CI: 0.01-2.00; median total dose: 7375 mg/m(2); interquartile range: 1300) were diagnosed with PJP.

Conclusion: There was a <1% rate of PJP for brain tumor patients treated with temozolomide until progression without PJP prophylaxis.

Keywords: Pneumocystis jirovecii; brain radiation; glioblastoma; temozolomide.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Alkylating / adverse effects*
  • Brain Neoplasms / drug therapy
  • Child
  • Dacarbazine / adverse effects
  • Dacarbazine / analogs & derivatives*
  • Female
  • Glioblastoma / drug therapy
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pneumonia, Pneumocystis / chemically induced*
  • Pneumonia, Pneumocystis / epidemiology*
  • Retrospective Studies
  • T-Lymphocytes / pathology
  • Temozolomide
  • Young Adult

Substances

  • Antineoplastic Agents, Alkylating
  • Dacarbazine
  • Temozolomide