Pneumocystis jirovecii pneumonia in non-Hodgkin's lymphoma after rituximab-based chemotherapy: a case series

doi:10.21037/tcr-22-1216

科研成果详情

题名	Pneumocystis jirovecii pneumonia in non-Hodgkin's lymphoma after rituximab-based chemotherapy: a case series
作者	Zhang, Qianying 1; Han, Liang2; Lin, Yuanyuan1; Sun, Xiaohong1; Ye, Haige1; Qian, Honglan1; Sun, Lan1; Jiang, Songfu1; Liang, Bin1
发表日期	2022-07
发表期刊	TRANSLATIONAL CANCER RESEARCH 影响因子和分区
语种	英语
原始文献类型	Article ; Early Access
关键词	Pneumocystis jirovecii pneumonia (PCP) non-Hodgkin?s lymphoma (NHL) rituximab case series
其他关键词	CARINII-PNEUMONIA ; MANAGEMENT ; DIAGNOSIS ; DISEASES ; MALIGNANCIES ; PROPHYLAXIS ; GUIDELINES ; EXPERIENCE ; INFECTION ; RISK
摘要	Background: The incidence of Pneumocystis jirovecii pneumonia (PCP) has been increasing in patients with hematologic malignancies due to the use of glucocorticoid therapy and immunosuppressive medication. The reports of PCP in non-Hodgkin's lymphoma (NHL) after rituximab-based chemotherapy are still rare. We reported a case series of PCP in NHL to show the clinical features and prognosis in those patients. Methods: We conducted a retrospective review of 15 NHL patients who developed PCP after rituximabbased chemotherapy during June 30, 2014 to June 1, 2020. We analyzed the laboratory and radiographic findings for those patients through descriptive statistics analysis. Results: The study revealed that PCP in NHL patients was complicated by chemotherapy after about 4 courses (range, 2 to 6 courses). Most patients had a standard lymphocyte count before treatment, and 14 of 15 patients (93.3%) had lymphopenia at the time of diagnosis of PCP. In addition to typical symptoms such as fever and dyspnea at the diagnosis of PCP, most patients had abnormal laboratory indexes such as marked elevations of C-reactive protein (CRP) and lactic dehydrogenase (LDH) both before and at the time of diagnosis. The (1,3)-(3-D-glucan test was also revealed as a sensitive index for PCP. Bilateral ground-glass opacity was detected in 14 cases through computed tomography (CT) scans. Positive results of microbiological testing were observed in 7 cases; sputum culture was positive in 3 and next-generation sequencing (NGS) was positive in 3 of these 7 patients, and the other case was positive in both sputum culture and NGS. Patients received high-dose trimethoprim/sulfamethoxazole (TMP/SMZ), caspofungin, and steroids as the treatment for PCP. Ventilatory support was required by 3 patients, so they were admitted to the intensive care unit (ICU), and 1 patient died from PCP. Conclusions: Dynamic monitoring of CRP, LDH, and (1,3)-(3-D-glucan test during the treatment of NHL may have a predictive value for the diagnosis of PCP. Additionally, we should use NGS as a rapid and sensitive method for the early diagnosis of PCP. When patients are classified as 'probable PCP', early and effective treatment has obvious significance to improve the prognosis.
资助项目	Natural Science Foundation of Zhejiang Province [LY20H080004]; Major R&D Project of Wenzhou Science and Technology Bureau [ZY2021013]
出版者	AME PUBL CO
出版地	SHATIN
ISSN	2218-676X
EISSN	2219-6803
卷号	11 期号:7 页码:2291-2298
DOI	10.21037/tcr-22-1216
页数	8
WOS类目	Oncology
WOS研究方向	Oncology
WOS记录号	WOS:000823477700001
收录类别	SCIE ; PUBMED ; SCOPUS
URL	查看原文
PubMed ID	35966314
SCOPUSEID	2-s2.0-85135228296
通讯作者地址	[Jiang, Songfu]Department of Hematology,Wenzhou Key Laboratory of Hematology,The First Affiliated Hospital of Wenzhou Medical University,South Baixiang Street,Wenzhou,325015,China ; [Liang, Bin]Department of Hematology,Wenzhou Key Laboratory of Hematology,The First Affiliated Hospital of Wenzhou Medical University,South Baixiang Street,Wenzhou,325015,China
Scopus学科分类	Oncology;Radiology, Nuclear Medicine and Imaging;Cancer Research
引用统计	被引频次[WOS]：0 [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/154530
专题	附属第一医院附属第一医院_耳鼻咽喉科
通讯作者	Jiang, Songfu; Liang, Bin
作者单位	1.Department of Hematology,Wenzhou Key Laboratory of Hematology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,China; 2.Department of Otorhinolaryngology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,China
第一作者单位	附属第一医院; 第一临床医学院（信息与工程学院）、附属第一医院
通讯作者单位	附属第一医院; 第一临床医学院（信息与工程学院）、附属第一医院
第一作者的第一单位	附属第一医院
推荐引用方式 GB/T 7714	Zhang, Qianying,Han, Liang,Lin, Yuanyuan,et al. Pneumocystis jirovecii pneumonia in non-Hodgkin's lymphoma after rituximab-based chemotherapy: a case series[J]. TRANSLATIONAL CANCER RESEARCH,2022,11(7):2291-2298.
APA	Zhang, Qianying., Han, Liang., Lin, Yuanyuan., Sun, Xiaohong., Ye, Haige., ... & Liang, Bin. (2022). Pneumocystis jirovecii pneumonia in non-Hodgkin's lymphoma after rituximab-based chemotherapy: a case series. TRANSLATIONAL CANCER RESEARCH, 11(7), 2291-2298.
MLA	Zhang, Qianying,et al."Pneumocystis jirovecii pneumonia in non-Hodgkin's lymphoma after rituximab-based chemotherapy: a case series".TRANSLATIONAL CANCER RESEARCH 11.7(2022):2291-2298.