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Sci Rep. 2018 May 29;8(1):8321. doi: 10.1038/s41598-018-26743-4.

Pneumocystis jirovecii pneumonia in HIV-uninfected, rituximab treated non-Hodgkin lymphoma patients.

Author information

1
Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
2
Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
3
Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
4
Critical care center and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
5
School of Medicine, National Yang-Ming University, Taipei, Taiwan.
6
Transplantation laboratory, Department of Nephrology, Kidney Center, Chang Gung Memorial Hospital, Chang Gung School of Medicine, Chang Gung University, Linkou, Taiwan. georgepclai@gmail.com.
7
China Medical University Hospital, China Medical University, Taichung, Taiwan. georgepclai@gmail.com.

Abstract

Rituximab is associated with a higher incidence of Pneumocystis jirovecii pneumonia infection. Pneumocystis prophylaxis is advised in many immunocompromised populations treated with rituximab. However, the beneficial effect of pneumocystis prophylaxis in HIV-uninfected, rituximab-treated non-Hodgkin lymphoma (NHL) patients has not been assessed. Thus, we conducted this retrospective study to explore pneumocystis infection in HIV-uninfected NHL patients who received at least three courses of chemotherapy without haematopoietic stem cell transplantation using the Taiwan National Health Insurance Research Database. Patients who had rituximab-based chemotherapy were included in the experimental (rituximab) group, while the rest of the patients who did not receive any rituximab-based chemotherapy throughout the study period formed the control group. The prevalence rate of pneumocystis infection in the rituximab group (N = 7,554) was significantly higher than that in the control group (N = 4,604) (2.95% vs. 1.32%). The onset of pneumocystis infection occurred between 6 and 16 weeks after chemotherapy. Patients who had pneumocystis prophylaxis, whether or not they had a pneumocystis infection later in their treatment course, had significantly better first-year survival rates (73% vs. 38%). Regular pneumocystis prophylaxis should be considered in this group of patients.

PMID:
29844519
PMCID:
PMC5974272
DOI:
10.1038/s41598-018-26743-4
[Indexed for MEDLINE]
Free PMC Article

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