Quantification of the effect of chemotherapy and steroids on risk of Pneumocystis jiroveci among hospitalized patients with adult T-cell leukaemia

Toshiki Maeda, Akira Babazono, Takumi Nishi, Shinya Matsuda, Kiyohide Fushimi, Kenji Fujimori

Research output: Contribution to journalArticle

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Abstract

Summary: This study aimed to quantify the risks of Pneumocystis pneumonia (PCP) among adult T-cell leukaemia (ATL) patients without prophylaxis. We used hospital administrative data collected nationwide in Japan over 4 years. The research design was a retrospective cohort study. Subjects were 4369 patients diagnosed with ATL aged 18 years or older. The subjects were categorized into four treatment groups: no agent, chemotherapy, chemotherapy + steroids and steroids. We described the risks of PCP among ATL patients without prophylaxis. Risks of PCP were 3·2% for the no agent group, 9·7% for the chemotherapy group, 10·0% for the chemotherapy + steroids group and 16·6% for the steroids group. Logistic regression analyses showed that the chemotherapy, chemotherapy + steroids and steroids groups had significantly higher risk of PCP than did the no agent group [adjusted odds ratio (AOR) 3·30 (1·55-7·02), P = 0·002 for the chemotherapy group; AOR 3·35 (2·18-5·17), P < 0·001 for the chemotherapy + steroids group; AOR 6·12 (3·99-9·38), P < 0·001 for the steroids group]. In conclusion, the chemotherapy, chemotherapy + steroids and steroids groups had significantly higher risks of PCP. Prophylaxis for PCP among ATL patients being treated with chemotherapy, chemotherapy + steroids and steroids is highly recommended.

Original languageEnglish
Pages (from-to)501-506
Number of pages6
JournalBritish Journal of Haematology
Volume168
Issue number4
DOIs
Publication statusPublished - Feb 1 2015

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Pneumocystis carinii
Adult T Cell Leukemia Lymphoma
Steroids
Drug Therapy
Pneumocystis Pneumonia
Odds Ratio
Japan
Cohort Studies
Research Design

All Science Journal Classification (ASJC) codes

  • Hematology

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Quantification of the effect of chemotherapy and steroids on risk of Pneumocystis jiroveci among hospitalized patients with adult T-cell leukaemia. / Maeda, Toshiki; Babazono, Akira; Nishi, Takumi; Matsuda, Shinya; Fushimi, Kiyohide; Fujimori, Kenji.

In: British Journal of Haematology, Vol. 168, No. 4, 01.02.2015, p. 501-506.

Research output: Contribution to journalArticle

Maeda, Toshiki ; Babazono, Akira ; Nishi, Takumi ; Matsuda, Shinya ; Fushimi, Kiyohide ; Fujimori, Kenji. / Quantification of the effect of chemotherapy and steroids on risk of Pneumocystis jiroveci among hospitalized patients with adult T-cell leukaemia. In: British Journal of Haematology. 2015 ; Vol. 168, No. 4. pp. 501-506.
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