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Post-Transplant Events

Occurrence of Pneumocystis jiroveci pneumonia after allogeneic stem cell transplantation: a 6-year retrospective study

Bone Marrow Transplantation volume 36, pages 879–883 (2005)Cite this article

Summary:

Pneumocystis jiroveci pneumonia (PCP) has become a rare opportunistic infection due to the efficacy of prophylactic regimens. We conducted a 6-year retrospective study at our institution. A total of 13 cases of PCP were diagnosed among 519 patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) (2.5%). In three patients, PCP occurred within the first 5 months following HSCT. These severely immunocompromised patients were receiving prophylaxis and had concomitant aspergillosis that caused rapid death in two of them. In 10 other patients, PCP occurred a median of 14.5 months after HSCT. In all these patients, PCP prophylaxis had been discontinued, mainly because of the suspected bone-marrow toxicity of the prophylactic regimen. Median CD4+ T cell count was 131/μl at diagnosis. Seven of these 10 patients were receiving immunosuppressive therapy for chronic graft versus host disease and three had a relapse of their hematological malignancy. One patient died from PCP despite high doses of cotrimoxazole. We conclude that PCP is still occurring after allogeneic HSCT, mainly as a late complication in patients in whom PCP prophylaxis had been prematurely discontinued. Long-term PCP prophylaxis should be maintained in patients receiving immunosuppressive drugs, and in those with low CD4+ T cell counts or a relapse of their hematological malignancy.

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Authors and Affiliations

  1. Department of Infectious Diseases, Saint-Louis Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France

    N De Castro, S Neuville & J M Molina

  2. Department of Parasitology, Saint-Louis Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France

    C Sarfati & F Derouin

  3. Department of Hematology-Stem Cell Transplantation, Saint-Louis Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France

    P Ribaud, E Gluckman & G Socié

Authors
  1. N De Castro
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  2. S Neuville
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  3. C Sarfati
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  4. P Ribaud
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  5. F Derouin
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  6. E Gluckman
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  7. G Socié
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  8. J M Molina
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Corresponding author

Correspondence to N De Castro.

Additional information

This study was presented at the 44th Interscience Conference on Antimicrobial Agents and Chemotherapy, Washington DC, USA, October 30–November 2, 2004 (poster M-1055).

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De Castro, N., Neuville, S., Sarfati, C. et al. Occurrence of Pneumocystis jiroveci pneumonia after allogeneic stem cell transplantation: a 6-year retrospective study. Bone Marrow Transplant 36, 879–883 (2005). https://doi.org/10.1038/sj.bmt.1705149

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  • DOI: https://doi.org/10.1038/sj.bmt.1705149

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