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Type: Journal article
Title: The incidence, mortality and timing of Pneumocystis jiroveci pneumonia after hematopoietic cell transplantation: a CIBMTR analysis
Author: Williams, K.
Ahn, K.
Chen, M.
Aljurf, M.
Agwu, A.
Chen, A.
Walsh, T.
Szabolcs, P.
Boeckh, M.
Auletta, J.
Lindemans, C.
Zanis-Neto, J.
Malvezzi, M.
Lister, J.
De Toledo Codina, J.
Sackey, K.
Chakrabarty, J.
Ljungman, P.
Wingard, J.
Seftel, M.
et al.
Citation: Bone Marrow Transplantation, 2016; 51(4):573-580
Publisher: Nature Publishing Group
Issue Date: 2016
ISSN: 0268-3369
Statement of
KM Williams ...A Yong ... et al.
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.
Keywords: Humans
Pneumocystis carinii
Pneumonia, Pneumocystis
Hematopoietic Stem Cell Transplantation
Risk Factors
Description: Published online 4 January 2016
Rights: © 2016 Macmillan Publishers Limited. All rights reserved.
DOI: 10.1038/bmt.2015.316
Appears in Collections:Aurora harvest 7
Pathology publications

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