Incidence, clinical presentation, and outcomes of <i>Pneumocystis</i> pneumonia when utilizing Polymerase Chain Reaction-based diagnosis in patients with Hodgkin lymphoma

Barreto, Jason N.; Thompson, Carrie A.; Wieruszewski, Patrick M.; Pawlenty, Amanda G.; Mara, Kristin C.; Potter, Ashley; Tosh, Pritish K.; Limper, Andrew H.

doi:10.1080/10428194.2020.1786561

Cited by 4 publications

(3 citation statements)

References 52 publications

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“…In addition to the damage to the respiratory system of children, severe pneumonia also causes neurological, digestive, circulatory, and other dysfunctions, as well as cerebral edema, mental confusion, irregular respiratory rhythm, and even respiratory arrest (18)(19)(20). Pneumonia is type of pulmonary edema, with congestion caused by a variety of pathogens.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of phentolamine combined with ambroxol aerosol inhalation in the treatment of pediatric severe pneumonia and its effect on serum IL-10 and CRP levels

Li¹,

Wu²,

Zhang³

2022

Transl Pediatr

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Background:The aim of the present study was to determine the therapeutic effect of phentolamine combined with Ambroxol aerosol inhalation on pediatric severe pneumonia and its effect on serum interleukin-10 (IL-10) and C-reactive protein (CRP) levels.Methods: Eighty-five children with severe pneumonia treated in our hospital from November 2019 to November 2020 were selected as the research participants, and were divided into the routine group (n=41) and treatment group (n=44) according to odd and even admission numbers, respectively. Children in the first group received routine treatment, namely symptomatic treatment such as cough relief (e.g., expectorant) and defervescence, while those in the second group received phentolamine combined with Ambroxol aerosol inhalation. Clinical indexes of both groups before and after treatment were analyzed to determine the therapeutic effect of different treatment methods and serum IL-10 and CRP level changes.Results: There was no significant difference in general clinical data between the 2 groups (P>0.05). The duration of cough, fever, abnormal lung sound and lung shadow, and hospitalization time in the treatment group was significantly shorter than those in the routine group (P<0.001). The total clinical effective rate in the treatment group was significantly higher than that in the routine group (P<0.05). Forced vital capacity and peak expiratory flow rate levels were higher in both groups after treatment (P<0.05), and these were higher in the treatment group compared with the routine group after treatment (P<0.05). Serum IL-10 and CRP levels at T1 (2 days after treatment), T2 (5 days after treatment), and T3 (7 days after treatment) in the treatment group were significantly lower than those in the routine group (P<0.001). The total incidence of adverse reactions in the treatment group was significantly lower than that in the routine group (P<0.05).Conclusions: Phentolamine combined with Ambroxol aerosol inhalation can significantly improve the clinical symptoms of children with severe pneumonia, reduce the body's inflammatory response, and improve lung function safely.

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Section: Discussionmentioning

confidence: 99%

Efficacy of phentolamine combined with ambroxol aerosol inhalation in the treatment of pediatric severe pneumonia and its effect on serum IL-10 and CRP levels

Li¹,

Wu²,

Zhang³

2022

Transl Pediatr

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“…This is reiterated by studies that showed prophylaxis did not significantly decrease the incidence of PJP in this patient population [42]. While this is the current recommendation, the overall incidence and mortality associated with PJP in patients treated with ABVD is increased and thus, further research is necessary to clarify the optimal recommendations [41,42]. With regards to patients treated with BV + AVD, rates of PJP have been shown to be low (0.1-1.0%) and PJP prophylaxis is not recommended [39].…”

Section: Pjpmentioning

confidence: 74%

“…At this time, the general recommendation is that PJP prophylaxis is typically not necessary in patients with Hodgkin's lymphoma treated with ABVD [41]. This is reiterated by studies that showed prophylaxis did not significantly decrease the incidence of PJP in this patient population [42]. While this is the current recommendation, the overall incidence and mortality associated with PJP in patients treated with ABVD is increased and thus, further research is necessary to clarify the optimal recommendations [41,42].…”

Section: Pjpmentioning

confidence: 99%

Antimicrobial Prophylaxis in Lymphoma by Chemotherapy Regimen

Kossow,

Bennett,

Hoffmann

2023

J Cell Immunol

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Treatment of lymphomas involves a wide variety of chemotherapy, immunotherapy, and targeted-agents tailored to disease biology and patient characteristics. Each of these regimens carry their own risk of opportunistic infections in an immunocompromised population. In addition to the treatment associated immunosuppression, lymphoma itself is immunosuppressive. Lymphoma associated immunosuppression is secondary to increased production of abnormal lymphocytes resulting in decreased production of normally functioning lymphocytes. Additionally, lymphoma cells induce both humoral and cellular immunosuppression through effects on numerous cytokines, T-cells, myeloid-derived suppressor cells, and macrophages. Clinical trials, patient co-morbidities, and institutional preferences all play a role in determining the preferred antimicrobial prophylaxis. While there is a paucity of data on systematic reviews and guidelines for standardized chemotherapy regimens in lymphoma patients, the efficacy and recommendations for antimicrobial prophylaxis in specific chemotherapy regimens for lymphoma has not been fully reviewed. According to the National Comprehensive Cancer Network, lymphoma is generally regarded as an ‘intermediate risk’ cancer with regards to overall infection risk. This results in discordance between research data and clinical practice. This is reiterated in the SIGNIFICANT trial which reported that while guidelines previously advised against fluoroquinolone prophylaxis in lymphoma and solid cancers, a survey of 3,600 physicians revealed that 45% routinely used fluoroquinolone prophylaxis despite these recommendations. This review article analyzes numerous research studies with summarization of findings and antimicrobial prophylaxis recommendations based on specific lymphoma chemotherapy regimens. With regards to each specific chemotherapy regimen assessed, indications for antibacterial, anti-viral, anti-fungal, and Pneumocystis jiroveci pneumonia (PJP) prophylaxis were determined for each regimen. The degree of immunosuppression and the necessary prophylaxis varies across different regimens and lymphoma subgroups; and thus, an individualized approach is necessary to optimize the supportive care during lymphoma treatment.

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