Abstract | BACKGROUND:
Pneumocystis pneumonia (PcP) is an opportunistic fungal infection. Although T-cell immunity is classically related to Pneumocystis defense, recent data support roles for B lymphocytes in the development of PcP in animals, and we have observed several cases of PcP in patients receiving rituximab. These observations prompted a systematic review of our experience to define the spectrum of clinical presentations in which PcP has occurred in the setting of rituximab therapy. METHODS: Using a computer-based search, we reviewed the records of patients who received rituximab and developed PcP at Mayo Clinic Rochester over the years 1998 to 2011 to establish the underlying conditions, clinical course, possible risk factors, and potential association between this drug and the development of PcP. RESULTS: CONCLUSION: PcP can occur in association with rituximab, with the majority of cases having also received cytotoxic chemotherapy or significant doses of glucocorticoids. The clinical course of cases of PcP in patients treated with rituximab can be quite fulminant, with significant mortality. Primary prophylaxis should be considered in patients at risk, and secondary prophylaxis provided unless immune reconstitution is well assured.
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Authors | Isabel Martin-Garrido, Eva M Carmona, Ulrich Specks, Andrew H Limper |
Journal | Chest
(Chest)
Vol. 144
Issue 1
Pg. 258-265
(Jul 2013)
ISSN: 1931-3543 [Electronic] United States |
PMID | 23258406
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Chemical References |
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Agents
- Glucocorticoids
- Immunosuppressive Agents
- Rituximab
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Murine-Derived
(adverse effects, therapeutic use)
- Antineoplastic Agents
(adverse effects, therapeutic use)
- Drug Therapy
- Drug Therapy, Combination
- Female
- Glucocorticoids
(therapeutic use)
- Hematologic Neoplasms
(drug therapy)
- Humans
- Immunosuppressive Agents
(adverse effects, therapeutic use)
- Male
- Middle Aged
- Opportunistic Infections
(chemically induced, epidemiology)
- Pneumonia, Pneumocystis
(chemically induced, epidemiology)
- Prevalence
- Retrospective Studies
- Risk Factors
- Rituximab
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