Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Infections

The incidence, mortality and timing of Pneumocystis jiroveci pneumonia after hematopoietic cell transplantation: a CIBMTR analysis

Bone Marrow Transplantation volume 51, pages 573–580 (2016)Cite this article

Subjects

Abstract

Pneumocystis jiroveci pneumonia (PJP) is associated with high morbidity and mortality after hematopoietic stem cell transplantation (HSCT). Little is known about PJP infections after HSCT because of the rarity of disease given routine prophylaxis. We report the results of a Center for International Blood and Marrow Transplant Research study evaluating the incidence, timing, prophylaxis agents, risk factors and mortality of PJP after autologous (auto) and allogeneic (allo) HSCT. Between 1995 and 2005, 0.63% allo recipients and 0.28% auto recipients of first HSCT developed PJP. Cases occurred as early as 30 days to beyond a year after allo HSCT. A nested case cohort analysis with supplemental data (n=68 allo cases, n=111 allo controls) revealed that risk factors for PJP infection included lymphopenia and mismatch after HSCT. After allo or auto HSCT, overall survival was significantly poorer among cases vs controls (P=0.0004). After controlling for significant variables, the proportional hazards model revealed that PJP cases were 6.87 times more likely to die vs matched controls (P<0.0001). We conclude PJP infection is rare after HSCT but is associated with high mortality. Factors associated with GVHD and with poor immune reconstitution are among the risk factors for PJP and suggest that protracted prophylaxis for PJP in high-risk HSCT recipients may improve outcomes.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6

Similar content being viewed by others

References

  1. Gilroy SA, Bennett NJ . Pneumocystis pneumonia. Semin Respir Crit Care Med 2011; 32: 775–782.

    Article  Google Scholar 

  2. Wakefield AE, Peters SE, Banerji S, Bridge PD, Hall GS, Hawksworth DL et al. Pneumocystis carinii shows DNA homology with the ustomycetous red yeast fungi. Mol Microbiol 1992; 6: 1903–1911.

    Article  CAS  Google Scholar 

  3. Gluck T, Geerdes-Fenge HF, Straub RH, Raffenberg M, Lang B, Lode H et al. Pneumocystis carinii pneumonia as a complication of immunosuppressive therapy. Infection 2000; 28: 227–230.

    Article  CAS  Google Scholar 

  4. Tuan IZ, Dennison D, Weisdorf DJ . Pneumocystis carinii pneumonitis following bone marrow transplantation. Bone Marrow Transplant 1992; 10: 267–272.

    CAS  PubMed  Google Scholar 

  5. Wazir JF, Ansari NA . Pneumocystis carinii infection. Update and review. Arch Pathol Lab Med 2004; 128: 1023–1027.

    PubMed  Google Scholar 

  6. Torres HA, Chemaly RF, Storey R, Aguilera EA, Noqueras GM, Safdar A et al. Influence of type of cancer and hematopoietic stem cell transplantation on clinical presentation of Pneumocystis jiroveci pneumonia in cancer patients. Eur J Clin Microbiol Infect Dis 2006; 25: 382–388.

    Article  CAS  Google Scholar 

  7. Yoo JH, Lee DG, Choi SM, Choi JH, Park YH, Kim YJ et al. Infectious complications and outcomes after allogeneic hematopoietic stem cell transplantation in Korea. Bone Marrow Transplant 2004; 34: 497–504.

    Article  Google Scholar 

  8. Rodriguez M, Fishman JA . Prevention of infection due to Pneumocystis spp. in human immunodeficiency virus-negative immunocompromised patients. Clin Microbiol Rev 2004; 17: 770–782.

    Article  Google Scholar 

  9. Tasaka S, Tokuda H . Pneumocystis jirovecii pneumonia in non-HIV-infected patients in the era of novel immunosuppressive therapies. J Infect Chemother 2012; 18: 793–806.

    Article  CAS  Google Scholar 

  10. Green H, Paul M, Vidal L, Leibovici L . Prophylaxis for Pneumocystis pneumonia (PCP) in non-HIV immunocompromised patients. Cochrane Database Syst Rev 2007; 3: CD005590.

  11. De Castro N, Neuville S, Sarfati C, Ribaud P, Derouin F, Gluckman E et al. Occurrence of Pneumocystis jiroveci pneumonia after allogeneic stem cell transplantation: a 6-year retrospective study. Bone Marrow Transplant 2005; 36: 879–883.

    Article  CAS  Google Scholar 

  12. Mikaelsson L, Jacobsson G, Andersson R . Pneumocystis pneumonia—a retrospective study 1991-2001 in Gothenburg, Sweden. J Infect 2006; 53: 260–265.

    Article  Google Scholar 

  13. Kruger W, Russmann B, Kroger N, Salomon C, Ekopf N, Elsner HA et al. Early infections in patients undergoing bone marrow or blood stem cell transplantation—a 7 year single centre investigation of 409 cases. Bone Marrow Transplant 1999; 23: 589–597.

    Article  CAS  Google Scholar 

  14. Tomonari A, Takahashi S, Ooi J, Tsukada N, Konuma T, Kato S et al. No occurrence of Pneumocystis jiroveci (carinii) pneumonia in 120 adults undergoing myeloablative unrelated cord blood transplantation. Transpl Infect Dis 2008; 10: 303–307.

    Article  CAS  Google Scholar 

  15. Chapman JR, Marriott DJ, Chen SC, MacDonald PS . Post-transplant Pneumocystis jirovecii pneumonia—a re-emerged public health problem? Kidney Int 2013; 84: 240–243.

    Article  Google Scholar 

  16. Nankivell BJ, Firacative C, Kable K, Chen SC, Meyer W . Molecular epidemiology linking multihospital clusters of opportunistic Pneumocystis jirovecii pneumonia. Clin Infect Dis 2013; 57: 1058–1059.

    Article  CAS  Google Scholar 

  17. Morris A, Norris KA . Colonization by Pneumocystis jirovecii and its role in disease. Clin Microbiol Rev 2012; 25: 297–317.

    Article  CAS  Google Scholar 

  18. Dykewicz CA . Preventing opportunistic infections in bone marrow transplant recipients. Transpl Infect Dis 1999; 1: 40–49.

    Article  CAS  Google Scholar 

  19. Fontanet ACY, Roosnek E, Mohty B, Passweg JR . Cotrimoxazole myelotoxicity in hematopoietic SCT recipients: time for reappraisal. Bone Marrow Transplant 2011; 46: 1272–1273.

    Article  CAS  Google Scholar 

  20. Colby C, McAfee S, Sackstein R, Finkelstein D, Fishman J, Spitzer T . A prospective randomized trial comparing the toxicity and safety of atovaquone with trimethoprim/sulfamethoxazole as Pneumocystis carinii pneumonia prophylaxis following autologous peripheral blood stem cell transplantation. Bone Marrow Transplant 1999; 24: 897–902.

    Article  CAS  Google Scholar 

  21. Fishman JA . Prevention of infection caused by Pneumocystis carinii in transplant recipients. Clin Infect Dis 2001; 33: 1397–1405.

    Article  CAS  Google Scholar 

  22. Sangiolo D, Storer B, Nash R, Corey L, Davis C, Flowers M et al. Toxicity and efficacy of daily dapsone as Pneumocystis jiroveci prophylaxis after hematopoietic stem cell transplantation: a case-control study. Biol Blood Marrow Transplant 2005; 11: 521–529.

    Article  CAS  Google Scholar 

  23. Marras TK, Sanders K, Lipton JH, Messner HA, Conly J, Chan CK . Aerosolized pentamidine prophylaxis for Pneumocystis carinii pneumonia after allogeneic marrow transplantation. Transpl Infect Dis 2002; 4: 66–74.

    Article  CAS  Google Scholar 

  24. Ramesh M, Chandrasekar PH . Effective alternates to trimethoprim-sulfamethoxazole as antimicrobial prophylaxis in stem cell recipients: are there any? Pediatr Transplant 2008; 12: 823–826.

    Article  CAS  Google Scholar 

  25. Utili R, Durante-Mangoni E, Basilico C, Mattei A, Ragone E, Grossi P . Efficacy of caspofungin addition to trimethoprim-sulfamethoxazole treatment for severe pneumocystis pneumonia in solid organ transplant recipients. Transplantation 2007; 84: 685–688.

    Article  CAS  Google Scholar 

  26. Rodriguez M, Sifri CD, Fishman JA . Failure of low-dose atovaquone prophylaxis against Pneumocystis jiroveci infection in transplant recipients. Clin Infect Dis 2004; 38: e76–e78.

    Article  CAS  Google Scholar 

  27. Maltezou HC, Petropoulos D, Choroszy M, Gardner M, Mantzouranis EC, Rolston KV et al. Dapsone for Pneumocystis carinii prophylaxis in children undergoing bone marrow transplantation. Bone Marrow Transplant 1997; 20: 879–881.

    Article  CAS  Google Scholar 

  28. Vasconcelles MJ, Bernardo MV, King C, Weller EA, Antin JH . Aerosolized pentamidine as pneumocystis prophylaxis after bone marrow transplantation is inferior to other regimens and is associated with decreased survival and an increased risk of other infections. Biol Blood Marrow Transplant 2000; 6: 35–43.

    Article  CAS  Google Scholar 

  29. Souza JP, Boeckh M, Gooley TA, Flowers ME, Crawford SW . High rates of Pneumocystis carinii pneumonia in allogeneic blood and marrow transplant recipients receiving dapsone prophylaxis. Clin Infect Dis 1999; 29: 1467–1471.

    Article  CAS  Google Scholar 

  30. Afessa B, Peters SG . Major complications following hematopoietic stem cell transplantation. Semin Respir Crit Care Med 2006; 27: 297–309.

    Article  Google Scholar 

  31. Gea-Banacloche J, Masur H, Arns da Cunha C, Chiller T, Kirchhoff LV, Shaw P et al. Regionally limited or rare infections: prevention after hematopoietic cell transplantation. Bone Marrow Transplant 2009; 44: 489–494.

    Article  CAS  Google Scholar 

  32. Sepkowitz KA, Brown AE, Telzak EE, Gottlieb S, Armstrong D . Pneumocystis carinii pneumonia among patients without AIDS at a cancer hospital. JAMA 1992; 267: 832–837.

    Article  CAS  Google Scholar 

  33. Russian DA, Levine SJ . Pneumocystis carinii pneumonia in patients without HIV infection. Am J Med Sci 2001; 321: 56–65.

    Article  CAS  Google Scholar 

  34. Roux A, Gonzalez F, Roux M, Mehrad M, Menotti J, Zahar JR et al. Update on pulmonary Pneumocystis jirovecii infection in non-HIV patients. Med Mal Infect 2014; 44: 185–198.

    Article  CAS  Google Scholar 

  35. Worth LJ, Dooley MJ, Seymour JF, Mileshkin L, Slavin MA, Thursky KA . An analysis of the utilisation of chemoprophylaxis against Pneumocystis jirovecii pneumonia in patients with malignancy receiving corticosteroid therapy at a cancer hospital. Br J Cancer 2005; 92: 867–872.

    Article  CAS  Google Scholar 

  36. Ahuja J, Kanne JP . Thoracic infections in immunocompromised patients. Radiol Clin North Am 2014; 52: 121–136.

    Article  Google Scholar 

  37. Saito T, Seo S, Kanda Y, Shoji N, Ogasawara T, Murakami J et al. Early onset Pneumocystis carinii pneumonia after allogeneic peripheral blood stem cell transplantation. Am J Hematol 2001; 67: 206–209.

    Article  CAS  Google Scholar 

  38. Bjorklund A, Aschan J, Labopin M, Remberger M, Ringden O, Winiarski J et al. Risk factors for fatal infectious complications developing late after allogeneic stem cell transplantation. Bone Marrow Transplant 2007; 40: 1055–1062.

    Article  CAS  Google Scholar 

  39. Roblot F, Le Moal G, Kauffmann-Lacroix C, Bastides F, Boutoille D, Verdon R et al. Pneumocystis jirovecii pneumonia in HIV-negative patients: a prospective study with focus on immunosuppressive drugs and markers of immune impairment. Scand J Infect Dis 2014; 46: 210–214.

    Article  CAS  Google Scholar 

  40. Lee EW, Wei LJ, Amato DA Cox-type regression analysis for large numbers of small groups of correlated failure time observations". In: Klein JP and Goel PK (eds). Survival Analysis: State of the Art. Kluwer Academic Publishers: Dordrecht, Netherlands, 1992 pp 237–247.

    Google Scholar 

  41. Olsson M, Eriksson BM, Elvin K, Strandberg M, Wahlgren M . Genotypes of clustered cases of Pneumocystis carinii pneumonia. Scand J Infect Dis 2001; 33: 285–289.

    Article  CAS  Google Scholar 

  42. Damiani C, Le Gal S, Da Costa C, Virmaux M, Nevez G, Totet A . Combined quantification of pulmonary Pneumocystis jirovecii DNA and serum (1-&gt;3)-beta-D-glucan for differential diagnosis of pneumocystis pneumonia and Pneumocystis colonization. J Clin Microbiol 2013; 51: 3380–3388.

    Article  CAS  Google Scholar 

  43. Esteves F, Lee CH, de Sousa B, Badura R, Seringa M, Fernandes C et al. (1-3)-Beta-D-glucan in association with lactate dehydrogenase as biomarkers of Pneumocystis pneumonia (PcP) in HIV-infected patients. Eur J Clin Microbiol Infect Dis 2014; 33: 1173–1180.

    Article  CAS  Google Scholar 

  44. Fan LC, Lu HW, Cheng KB, Li HP, Xu JF . Evaluation of PCR in bronchoalveolar lavage fluid for diagnosis of Pneumocystis jirovecii pneumonia: a bivariate meta-analysis and systematic review. PloS ONE 2013; 8: e73099.

    Article  CAS  Google Scholar 

  45. Maillet M, Maubon D, Brion JP, Francois P, Molina L, Stahl JP et al. Pneumocystis jirovecii (Pj) quantitative PCR to differentiate Pj pneumonia from Pj colonization in immunocompromised patients. Eur J Clin Microbiol Infect Dis 2014; 33: 331–336.

    Article  CAS  Google Scholar 

  46. Matsumura Y, Ito Y, Yamamoto M, Matsushima A, Nagao M, Takakura S et al. Pneumocystis polymerase chain reaction and blood (1—&gt;3)-beta-D-glucan assays to predict survival with suspected Pneumocystis jirovecii pneumonia. J Infect Chemother 2014; 20: 109–114.

    Article  CAS  Google Scholar 

  47. Olsson M, Stralin K, Holmberg H . Clinical significance of nested polymerase chain reaction and immunofluorescence for detection of Pneumocystis carinii pneumonia. Clin Microbiol Infect 2001; 7: 492–497.

    Article  CAS  Google Scholar 

  48. Tasaka S, Tokuda H . Recent advances in the diagnosis of Pneumocystis jirovecii pneumonia in HIV-infected adults. Expert Opin Med Diagn 2013; 7: 85–97.

    Article  CAS  Google Scholar 

  49. Coyle PV, McCaughey C, Nager A, McKenna J, O'Neill H, Feeney SA et al. Rising incidence of Pneumocystis jirovecii pneumonia suggests iatrogenic exposure of immune-compromised patients may be becoming a significant problem. J Med Microbiol 2012; 61: 1009–1015.

    Article  CAS  Google Scholar 

  50. Maini R, Henderson KL, Sheridan EA, Lamagni T, Nichols G, Delpech V et al. Increasing Pneumocystis pneumonia, England, UK, 2000-2010. Emerg Infect Dis 2013; 19: 386–392.

    Article  Google Scholar 

  51. Madden RM, Pui CH, Hughes WT, Flynn PM, Leung W . Prophylaxis of Pneumocystis carinii pneumonia with atovaquone in children with leukemia. Cancer 2007; 109: 1654–1658.

    Article  CAS  Google Scholar 

  52. Meyers B, Borrego F, Papanicolaou G . Pneumocystis carinii pneumonia prophylaxis with atovaquone in trimethoprim-sulfamethoxazole-intolerant orthotopic liver transplant patients: a preliminary study. Liver Transpl 2001; 7: 750–751.

    Article  CAS  Google Scholar 

  53. Shankar SM, Nania JJ . Management of Pneumocystis jiroveci pneumonia in children receiving chemotherapy. Paediatr Drugs 2007; 9: 301–309.

    Article  Google Scholar 

  54. Neumann S, Krause SW, Maschmeyer G, Schiel X, von Lilienfeld-Toal M . Primary prophylaxis of bacterial infections and Pneumocystis jirovecii pneumonia in patients with hematological malignancies and solid tumors: guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Ann Hematol 2013; 92: 433–442.

    Article  CAS  Google Scholar 

  55. Overgaard UM, Helweg-Larsen J . Pneumocystis jiroveci pneumonia (PCP) in HIV-1-negative patients: a retrospective study 2002-2004. Scand J Infect Dis 2007; 39: 589–595.

    Article  Google Scholar 

  56. Williams KM, Hakim FT, Gress RE . T cell immune reconstitution following lymphodepletion. Semin Immunol 2007; 19: 318–330.

    Article  CAS  Google Scholar 

  57. Kim SY, Dabb AA, Glenn DJ, Snyder KM, Chuk MK, Loeb DM . Intravenous pentamidine is effective as second line Pneumocystis pneumonia prophylaxis in pediatric oncology patients. Pediatr Blood Cancer 2008; 50: 779–783.

    Article  Google Scholar 

  58. Debs RJ, Straubinger RM, Brunette EN, Lin JM, Lin EJ, Montgomery AB et al. Selective enhancement of pentamidine uptake in the lung by aerosolization and delivery in liposomes. Am Rev Respir Dis 1987; 135: 731–737.

    CAS  PubMed  Google Scholar 

  59. Williams S, MacDonald P, Hoyer JD, Barr RD, Athale UH . Methemoglobinemia in children with acute lymphoblastic leukemia (ALL) receiving dapsone for pneumocystis carinii pneumonia (PCP) prophylaxis: a correlation with cytochrome b5 reductase (Cb5R) enzyme levels. Pediatr Blood Cancer 2005; 44: 55–62.

    Article  Google Scholar 

  60. Queener SF, Cody V, Pace J, Torkelson P, Gangjee A . Trimethoprim resistance of dihydrofolate reductase variants from clinical isolates of Pneumocystis jirovecii. Antimicrob Agents Chemother 2013; 57: 4990–4998.

    Article  CAS  Google Scholar 

  61. Caselli D, Petris MG, Rondelli R, Carraro F, Colombini A, Muggeo P et al. Single-day trimethoprim/sulfamethoxazole prophylaxis for Pneumocystis pneumonia in children with cancer. J Pediatr 2014; 164: 389–392 e1.

    Article  CAS  Google Scholar 

  62. Link H, Vohringer HF, Wingen F, Bragas B, Schwardt A, Ehninger G . Pentamidine aerosol for prophylaxis of Pneumocystis carinii pneumonia after BMT. Bone Marrow Transplant 1993; 11: 403–406.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The CIBMTR is supported by Public Health Service Grant/Cooperative Agreement U24-CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); a Grant/Cooperative Agreement 5U10HL069294 from NHLBI and NCI; a contract HHSH250201200016C with Health Resources and Services Administration (HRSA/DHHS); two grants N00014-13-1-0039 and N00014-14-1-0028 from the Office of Naval Research; and grants from *Actinium Pharmaceuticals; Allos Therapeutics, Inc.; *Amgen, Inc.; Anonymous donation to the Medical College of Wisconsin; Ariad; Be the Match Foundation; *Blue Cross and Blue Shield Association; *Celgene Corporation; Chimerix, Inc.; Fred Hutchinson Cancer Research Center; Fresenius-Biotech North America, Inc.; *Gamida Cell Teva Joint Venture Ltd; Genentech, Inc.;*Gentium SpA; Genzyme Corporation; GlaxoSmithKline; Health Research, Inc. Roswell Park Cancer Institute; HistoGenetics, Inc.; Incyte Corporation; Jeff Gordon Children’s Foundation; Kiadis Pharma; The Leukemia & Lymphoma Society; Medac GmbH; The Medical College of Wisconsin; Merck & Co, Inc.; Millennium: The Takeda Oncology Co.; *Milliman USA, Inc.; *Miltenyi Biotec, Inc.; National Marrow Donor Program; Onyx Pharmaceuticals; Optum Healthcare Solutions, Inc.; Osiris Therapeutics, Inc.; Otsuka America Pharmaceutical, Inc.; Perkin Elmer, Inc.; *Remedy Informatics; *Sanofi US; Seattle Genetics; Sigma-Tau Pharmaceuticals; Soligenix, Inc.; St. Baldrick’s Foundation; StemCyte, A Global Cord Blood Therapeutics Co.; Stemsoft Software, Inc.; Swedish Orphan Biovitrum; *Tarix Pharmaceuticals; *TerumoBCT; *Teva Neuroscience, Inc.; *THERAKOS, Inc.; University of Minnesota; University of Utah; and *Wellpoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration (HRSA) or any other agency of the U.S. Government.

Author information

Authors and Affiliations

  1. Children’s Research Institute, Children’s National Health System, Washington, DC, USA

    K M Williams

  2. Department of Medicine, CIBMTR® (Center for International Blood and Marrow Transplant Research), Medical College of Wisconsin, Milwaukee, WI, USA

    K W Ahn & M Chen

  3. Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA

    K W Ahn

  4. Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia

    M D Aljurf

  5. Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    A L Agwu & A R Chen

  6. Division of Blood and Marrow Transplantation and Cellular Therapies, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA

    T J Walsh

  7. Department of Medicine, Weill Cornell Medical College, New York, NY, USA

    P Szabolcs & S Seo

  8. Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    M J Boeckh

  9. Divisions of Hematology/Oncology, Bone Marrow Transplantation and Infectious Diseases, Nationwide Children’s Hospital, Columbus, OH, USA

    J J Auletta

  10. Pediatric Blood and Marrow Transplantation Program, University Medical Center Utrecht, Utrecht, Netherlands

    C A Lindemans

  11. Hospital de Clínicas – Universidade Federal do Paraná, Curitiba, Brazil

    J Zanis-Neto & M Malvezzi

  12. Cell Transplantation Program, Western Pennsylvania Cancer Institute, , Pittsburgh, PA, USA

    J Lister

  13. Haematology and SCT Department, Paediatric Oncology, Hospital Infantil Vall d’Hebron, Barcelona, Spain

    J S de Toledo Codina

  14. Department of Pediatric Hematology/Oncology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia

    K Sackey

  15. Department of Hematology/Oncology, University of Oklahoma, Oklahoma City, OK, USA

    J L H Chakrabarty

  16. Department of Hematology, Karolinska University, Stockholm, Sweden

    P Ljungman

  17. Division of Hematology & Oncology, Department of Medicine, University of Florida, Gainesville, FL, USA

    J R Wingard

  18. Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada

    M D Seftel

  19. Department of Hematology/Oncology, All Children’s Hospital, St. Petersburg, FL, USA

    G A Hale

  20. Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA, USA

    B Wirk

  21. Viracor-IBT Laboratories, Lee’s Summit, MO, USA

    M S Smith

  22. Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    B N Savani

  23. Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH, USA

    H M Lazarus

  24. Pediatric Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, UK

    D I Marks

  25. Division of Hematology, Department of Medicine, Oncology and Transplantation, University of Minnesota Medical Center, Minneapolis, MN, USA

    C Ustun

  26. Division of Hematology, Oncology and Blood & Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA, USA

    H Abdel-Azim

  27. Department of Pediatrics, University of California San Francisco Medical Center, San Francisco, CA, USA

    C C Dvorak

  28. Department Clinical Haematology and Bone Marrow Transplantation, Royal Melbourne Hospital, Victoria, Australia

    J Szer

  29. Department of Medicine, University of Calgary, Calgary, Alberta, Canada

    J Storek

  30. Royal Adelaide Hospital/SA Pathology and School of Medicine, University of Adelaide, Adelaide, Australia

    A Yong

  31. Division of Hematology and Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA

    M R Riches

Authors
  1. K M Williams
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K W Ahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M D Aljurf
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A L Agwu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A R Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. T J Walsh
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. P Szabolcs
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. M J Boeckh
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. J J Auletta
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. C A Lindemans
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. J Zanis-Neto
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. M Malvezzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. J Lister
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. J S de Toledo Codina
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. K Sackey
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. J L H Chakrabarty
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. P Ljungman
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. J R Wingard
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. M D Seftel
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. S Seo
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. G A Hale
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. B Wirk
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. M S Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  25. B N Savani
    View author publications

    You can also search for this author in PubMed Google Scholar

  26. H M Lazarus
    View author publications

    You can also search for this author in PubMed Google Scholar

  27. D I Marks
    View author publications

    You can also search for this author in PubMed Google Scholar

  28. C Ustun
    View author publications

    You can also search for this author in PubMed Google Scholar

  29. H Abdel-Azim
    View author publications

    You can also search for this author in PubMed Google Scholar

  30. C C Dvorak
    View author publications

    You can also search for this author in PubMed Google Scholar

  31. J Szer
    View author publications

    You can also search for this author in PubMed Google Scholar

  32. J Storek
    View author publications

    You can also search for this author in PubMed Google Scholar

  33. A Yong
    View author publications

    You can also search for this author in PubMed Google Scholar

  34. M R Riches
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K M Williams.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Williams, K., Ahn, K., Chen, M. et al. The incidence, mortality and timing of Pneumocystis jiroveci pneumonia after hematopoietic cell transplantation: a CIBMTR analysis. Bone Marrow Transplant 51, 573–580 (2016). https://doi.org/10.1038/bmt.2015.316

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2015.316

This article is cited by

Search

Advanced search

Quick links