Document Detail

Increased incidence of interstitial pneumonia by CHOP combined with rituximab.
MedLine Citation:
PMID:  18409079     Owner:  NLM     Status:  MEDLINE    
Several authors have reported interstitial pneumonia (IP) during rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy, while others have encountered Pneumocystis jirovecii pneumonia during rituximab-combined bi-weekly CHOP. Herein, we report that 13 of 90 (14%) patients developed IP during R-CHOP therapy, compared with none of 105 patients treated with CHOP alone as a historical control. There were no differences in baseline data between patients undergoing the two therapies. Among R-CHOP-treated patients, serum beta-D-glucan was increased in 8 of 12 (75%) IP patients compared with none of 30 non-IP patients examined. In five IP patients who underwent sputum evaluation, two were positive for P. jirovecii by the polymerase chain reaction and another two were positive for Candida albicans. No other organisms were detected as causative pathogens. Treatment with steroids, sulfamethoxazole-trimethoprim (ST), and antifungals was effective. Our results suggest that R-CHOP raises the incidence of IP, possibly through increasing the susceptibility to P. jirovecii and fungal infection. The need for prophylactic antifungals and ST during R-CHOP should be evaluated by randomized controlled trials.
Daisuke Ennishi; Yasuhito Terui; Masahiro Yokoyama; Yuko Mishima; Shunji Takahashi; Kengo Takeuchi; Kazuma Ikeda; Mitsune Tanimoto; Kiyohiko Hatake
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of hematology     Volume:  87     ISSN:  0925-5710     ISO Abbreviation:  Int. J. Hematol.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-10-30     Completed Date:  2009-04-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111627     Medline TA:  Int J Hematol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  393-7     Citation Subset:  IM    
Department of Oncology and Hematology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo 135-8550, Japan.
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MeSH Terms
Aged, 80 and over
Antibodies, Monoclonal / therapeutic use*
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Cyclophosphamide / therapeutic use
Doxorubicin / therapeutic use
Lung Diseases, Interstitial / metabolism,  pathology*
Lymphoma / drug therapy,  immunology
Middle Aged
Prednisone / therapeutic use
Vincristine / therapeutic use
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/CHOP protocol; 0/rituximab; 23214-92-8/Doxorubicin; 50-18-0/Cyclophosphamide; 53-03-2/Prednisone; 57-22-7/Vincristine

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