Document Detail


Pneumocystis carinii pneumonia in patients with hematologic malignancies: a descriptive study.
MedLine Citation:
PMID:  12850158     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Objectives. A retrospective multicentric study was conducted over a five-year period to evaluate the clinical and laboratory characteristics and outcome of patients with proven Pneumocystis carinii pneumonia (PCP) complicating hematologic malignancies.Results. The study included 60 HIV-negative patients with 18 non-Hodgkin's malignant lymphoma (30%), 13 chronic lymphocytic leukaemia (21.7%), 10 acute leukemia (16.6%), 5 multiple myeloma (8.3%), 4 Waldenstr?m's diseases (6.6%), 4 chronic myeloid leukemia (6.6%), 3 myelodysplasia (5%), 2 Hodgkin's diseases (3.3%) and 1 thrombopenia. Bronchoalveolar lavage was diagnostic in all patients. Forty-nine patients received cytotoxic drugs (81.7%), 25 (41.7%) a long-term corticotherapy and 15 (25%) underwent bone marrow transplantation. Twenty-seven patients (45%) required admission in the intensive care unit, 35 (58.3%) received an adjunctive corticotherapy and 18 mechanical ventilation (30%). Twenty patients (33.3%) died of PCP. A previous long-term corticotherapy (p=0.04), high respiratory (p=0.05) and pulse rates (p=0.02), elevated C reactive protein (p=0.01) and mechanical ventilation (OR=13.37; IC: 1.9-50) were associated with a poor prognosis. Adjunctive corticotherapy did not modify the prognosis.Conclusions. These results suggest that PCP can occur during the course of various hematologic malignancies, not only lymphoproliferative disorders. Prognosis remains poor. The diagnosis should be advocated more frequently and earlier to improve the prognosis.
Authors:
F Roblot; G Le Moal; C Godet; P Hutin; M Texereau; E Boyer; T Prazuck; C Lacroix; M Faouzi Souala; F Raffi; P Weinbreck; J M Besnier; B Garo; L de Gentile; B Becq-Giraudon
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  The Journal of infection     Volume:  47     ISSN:  0163-4453     ISO Abbreviation:  J. Infect.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-09     Completed Date:  2003-10-27     Revised Date:  2010-03-23    
Medline Journal Info:
Nlm Unique ID:  7908424     Medline TA:  J Infect     Country:  England    
Other Details:
Languages:  eng     Pagination:  19-27     Citation Subset:  IM    
Affiliation:
Infectious Diseases Unit, Department of Internal Medicine, University Hospital, Poitiers, France. f.roblot@chu-poitiers.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
France / epidemiology
Hematologic Neoplasms / complications*,  epidemiology
Humans
Male
Middle Aged
Pneumonia, Pneumocystis / complications*,  epidemiology*
Prevalence
Prognosis
Retrospective Studies
Severity of Illness Index
Statistics, Nonparametric

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