Department of Pharmacy, Mayo Clinic, Rochester, MN, USA.
Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Leuk Lymphoma. 2020 Nov;61(11):2622-2629. doi: 10.1080/10428194.2020.1786561. Epub 2020 Jul 5.
A Polymerase Chain Reaction-based diagnosis of Pneumonia (PCP) and the need for anti- prophylaxis in Hodgkin lymphoma patients receiving chemotherapy requires further investigation. This retrospective, single-center, study evaluated 506 consecutive adult patients diagnosed with Hodgkin lymphoma receiving chemotherapy between January 2006 and August 2018. The cumulative incidence of PCP 1 year after start of chemotherapy was 6.2% (95% CI 3.8-8.5%). Mortality 30 days from PCP diagnosis was 8% ( = 2) with one death attributable to PCP. Bleomycin-containing combination chemotherapy regimen was not significantly associated with a higher risk for PCP when compared to other regimens (HR = 1.59, 95% CI 0.55-4.62 = 0.40). Anti- prophylaxis was not significantly associated with a decreased incidence of PCP (HR = 0.51, 95% CI 0.15-1.71, = 0.28). As the overall incidence is above the commonly accepted 3.5% threshold, clinicians should consider the potential value of prophylaxis. The utility of universal vs. targeted anti- prophylaxis requires prospective, randomized investigation.
基于聚合酶链反应的肺炎(PCP)诊断和接受化疗的霍奇金淋巴瘤患者抗预防的需求需要进一步研究。这项回顾性、单中心研究评估了 2006 年 1 月至 2018 年 8 月期间接受化疗的 506 例连续确诊的霍奇金淋巴瘤成年患者。化疗开始后 1 年 PCP 的累积发生率为 6.2%(95%CI3.8-8.5%)。PCP 诊断后 30 天的死亡率为 8%( = 2),其中 1 例死亡归因于 PCP。与其他方案相比,含博来霉素的联合化疗方案与 PCP 的高风险无显著相关性(HR=1.59,95%CI0.55-4.62, = 0.40)。抗预防与 PCP 发生率降低无显著相关性(HR=0.51,95%CI0.15-1.71, = 0.28)。由于总发生率高于普遍接受的 3.5%阈值,临床医生应考虑预防的潜在价值。普遍和有针对性的抗预防的效用需要前瞻性、随机研究。