Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov;61(11):2622-2629.
doi: 10.1080/10428194.2020.1786561. Epub 2020 Jul 5.

Incidence, clinical presentation, and outcomes of Pneumocystis pneumonia when utilizing Polymerase Chain Reaction-based diagnosis in patients with Hodgkin lymphoma

Jason N Barreto  1 , Carrie A Thompson  2 , Patrick M Wieruszewski  1 , Amanda G Pawlenty  1 , Kristin C Mara  3 , Ashley L Potter  1 , Pritish K Tosh  4 , Andrew H Limper  5
Affiliations

Incidence, clinical presentation, and outcomes of Pneumocystis pneumonia when utilizing Polymerase Chain Reaction-based diagnosis in patients with Hodgkin lymphoma

Jason N Barreto et al. Leuk Lymphoma. 2020 Nov.

Abstract

A Polymerase Chain Reaction-based diagnosis of Pneumocystis Pneumonia (PCP) and the need for anti-Pneumocystis prophylaxis in Hodgkin lymphoma patients receiving chemotherapy requires further investigation. This retrospective, single-center, study evaluated 506 consecutive adult patients diagnosed with Hodgkin lymphoma receiving chemotherapy between January 2006 and August 2018. The cumulative incidence of PCP 1 year after start of chemotherapy was 6.2% (95% CI 3.8-8.5%). Mortality 30 days from PCP diagnosis was 8% (n = 2) with one death attributable to PCP. Bleomycin-containing combination chemotherapy regimen was not significantly associated with a higher risk for PCP when compared to other regimens (HR = 1.59, 95% CI 0.55-4.62 p = 0.40). Anti-Pneumocystis prophylaxis was not significantly associated with a decreased incidence of PCP (HR = 0.51, 95% CI 0.15-1.71, p = 0.28). As the overall incidence is above the commonly accepted 3.5% threshold, clinicians should consider the potential value of prophylaxis. The utility of universal vs. targeted anti-Pneumocystis prophylaxis requires prospective, randomized investigation.

Keywords: Pneumocystis jirovecii; Hodgkin lymphoma; Polymerase Chain Reaction; infection; pneumonia; sulfamethoxazole; trimethoprim.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of Interest:

None of the authors have any financial or other conflicts of interest relevant to the contents of this manuscript.

Figures

Figure 1.
Figure 1.
Cumulative incidence and 95% confidence bands of PCP 1 year after start of chemo in patients with Hodgkin lymphoma receiving chemotherapy.
See this image and copyright information in PMC

References

    1. Festic E, Gajic O, Limper AH, Aksamit TR. Acute respiratory failure due to pneumocystis pneumonia in patients without human immunodeficiency virus infection: outcome and associated features. Chest 2005;128:573–579. - PubMed
    1. Sepkowitz KA, Brown AE, Armstrong D. Pneumocystis carinii pneumonia without acquired immunodeficiency syndrome. More patients, same risk. Arch Intern Med 1995;155:1125–1128. - PubMed
    1. Roembke F, Heinzow HS, Gosseling T, et al. Clinical outcome and predictors of survival in patients with pneumocystis jirovecii pneumonia--results of a tertiary referral centre. Clin Respir J 2014;8:86–92. - PubMed
    1. Obeid KM, Aguilar J, Szpunar S, et al. Risk factors for Pneumocystis jirovecii pneumonia in patients with lymphoproliferative disorders. Clin Lymphoma Myeloma Leuk 2012;12:66–69. - PubMed
    1. Barreto JN, Ice LL, Thompson CA, et al. Low incidence of pneumocystis pneumonia utilizing PCR-based diagnosis in patients with B-cell lymphoma receiving rituximab-containing combination chemotherapy. Am J Hematol 2016;91:1113–1117. - PubMed

Publication types

MeSH terms

Substances