High incidence of Pneumocystis jirovecii pneumonia in patients receiving biweekly rituximab and cyclophosphamide, adriamycin, vincristine, and prednisone

Sarah Kamel, Shaun O'Connor, Newton Lee, Robin J A Filshie, Harshal Hanumant Nandurkar, Constantine S Tam

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56 Citations (Scopus)


The risk of infection with Pneumocystis jirovecii pneumonia (PCP) in patients undergoing chemotherapy is closely related to the intensity of corticosteroid exposure. PCP is uncommon with classical (3-weekly) R-CHOP, but the risk may be higher with biweekly R-CHOP (R-CHOP-14) due to the increased frequency of prednisolone pulses. Among 47 consecutive patients treated with R-CHOP-14 at our institution, five (11) developed microbiologically proven PCP, with a further two (4) having classical clinical and radiological features of PCP, but without microbiological confirmation. None of these patients were HIV-positive or had additional risk factors for PCP. Our experience suggests that PCP prophylaxis should be considered in institutions using R-CHOP-14 for the treatment of patients with aggressive lymphomas.
Original languageEnglish
Pages (from-to)797 - 801
Number of pages5
JournalLeukemia and Lymphoma
Issue number5
Publication statusPublished - 2010
Externally publishedYes

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