Désirée Caselli1, Maria Grazia Petris2, Roberto Rondelli3, Francesca Carraro4, Antonella Colombini5, Paola Muggeo6, Ottavio Ziino7, Fraia Melchionda3, Giovanna Russo8, Paolo Pierani9, Elena Soncini10, Raffaella DeSantis11, Giulio Zanazzo12, Angelica Barone13, Simone Cesaro14, Monica Cellini15, Rossella Mura16, Giuseppe M Milano17, Cristina Meazza18, Maria P Cicalese19, Serena Tropia7, Salvatore De Masi20, Elio Castagnola21, Maurizio Aricò22. 1. Department of Pediatric Hematology-Oncology, Azienda Ospedaliero Universitaria Meyer Children Hospital, Florence, Italy. 2. Pediatric Hematology-Oncology, Padua, Italy. 3. Pediatric Oncology and Hematology, Lalla Seràgnoli Unit, University of Bologna, Bologna, Italy. 4. Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Turin, Italy. 5. Pediatric Hematology-Oncology, Monza, Italy. 6. Pediatric Hematology-Oncology, Bari, Italy. 7. Pediatric Hematology-Oncology, ARNAS Civico, Palermo, Italy. 8. Pediatric Hematology-Oncology, Catania, Italy. 9. Division of Pediatric Hematology/Oncology, G Salesi Women's and Children's Hospital, Ancona, Italy. 10. Pediatric Hematology-Oncology, BMT Unit, Spedali Civili, Brescia, Italy. 11. Pediatric Hematology-Oncology, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy. 12. Pediatric Hematology-Oncology, Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy. 13. Pediatric and Hematology-Oncology, University Hospital Azienda Ospedaliero Universitaria di Parma, Parma, Italy. 14. Pediatric Hematology-Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy. 15. Pediatric Hematology-Oncology, University Hospital, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy. 16. Pediatric Hematology-Oncology, Cagliari, Italy. 17. Pediatric Oncology/Hematology, BMT Unit, Section of Hematology, Department of Internal and Experimental Medicine, University of Perugia, Perugia, Italy. 18. Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionaledei Tumori, Milan, Italy. 19. Pediatric Immunology, San Raffaele Telethon Institute for Gene Therapy, Milan, Italy. 20. Epidemiology, Azienda Ospedaliero Universitaria Meyer Children Hospital, Florence, Italy. 21. Infectious Disease Unit, Gaslini Institute, Istituto Giannina Gaslini, Genoa, Italy. 22. Department of Pediatric Hematology-Oncology, Azienda Ospedaliero Universitaria Meyer Children Hospital, Florence, Italy. Electronic address: maurizio.arico@ittumori.it.
Abstract
OBJECTIVE: To determine whether a simplified, 1-day/week regimen of trimethoprim/sulfamethoxazole is sufficient to prevent Pneumocystis (jirovecii [carinii]) pneumonia (PCP). Current recommended regimens for prophylaxis against PCP range from daily administration to 3 consecutive days per week dosing. STUDY DESIGN: A prospective survey of the regimens adopted for the PCP prophylaxis in all patients treated for childhood cancer at pediatric hematology-oncology centers of the Associazione Italiana Ematologia Oncologia Pediatrica. RESULTS: The 20 centers participating in the study reported a total of 2466 patients, including 1093 with solid tumor and 1373 with leukemia/lymphoma (or primary immunodeficiency; n = 2). Of these patients, 1371 (55.6%) received the 3-day/week prophylaxis regimen, 406 (16.5%) received the 2-day/week regimen, and 689 (27.9%), including 439 with leukemia/lymphoma, received the 1-day/week regimen. Overall, only 2 cases of PCP (0.08%) were reported, both in the 2-day/week group. By intention to treat, the cumulative incidence of PCP at 3 years was 0.09% overall (95% CI, 0.00-0.40%) and 0.51% for the 2-day/week group (95% CI, 0.10%-2.00%). Remarkably, both patients who failed had withdrawn from prophylaxis. CONCLUSION: A single-day course of prophylaxis with trimethoprim/sulfamethoxazole may be sufficient to prevent PCP in children with cancer undergoing intensive chemotherapy regimens. This simplified strategy might have implications for the emerging need for PCP prophylaxis in other patients subjected to the increased use of biological and nonbiological agents that induce higher levels of immune suppression, such as those with rheumatic diseases.
OBJECTIVE: To determine whether a simplified, 1-day/week regimen of trimethoprim/sulfamethoxazole is sufficient to prevent Pneumocystis (jirovecii [carinii]) pneumonia (PCP). Current recommended regimens for prophylaxis against PCP range from daily administration to 3 consecutive days per week dosing. STUDY DESIGN: A prospective survey of the regimens adopted for the PCP prophylaxis in all patients treated for childhood cancer at pediatric hematology-oncology centers of the Associazione Italiana Ematologia Oncologia Pediatrica. RESULTS: The 20 centers participating in the study reported a total of 2466 patients, including 1093 with solid tumor and 1373 with leukemia/lymphoma (or primary immunodeficiency; n = 2). Of these patients, 1371 (55.6%) received the 3-day/week prophylaxis regimen, 406 (16.5%) received the 2-day/week regimen, and 689 (27.9%), including 439 with leukemia/lymphoma, received the 1-day/week regimen. Overall, only 2 cases of PCP (0.08%) were reported, both in the 2-day/week group. By intention to treat, the cumulative incidence of PCP at 3 years was 0.09% overall (95% CI, 0.00-0.40%) and 0.51% for the 2-day/week group (95% CI, 0.10%-2.00%). Remarkably, both patients who failed had withdrawn from prophylaxis. CONCLUSION: A single-day course of prophylaxis with trimethoprim/sulfamethoxazole may be sufficient to prevent PCP in children with cancer undergoing intensive chemotherapy regimens. This simplified strategy might have implications for the emerging need for PCP prophylaxis in other patients subjected to the increased use of biological and nonbiological agents that induce higher levels of immune suppression, such as those with rheumatic diseases.
Authors: Jason N Barreto; Carrie A Thompson; Patrick M Wieruszewski; Amanda G Pawlenty; Kristin C Mara; Ashley L Potter; Pritish K Tosh; Andrew H Limper Journal: Leuk Lymphoma Date: 2020-07-05
Authors: K M Williams; K W Ahn; M Chen; M D Aljurf; A L Agwu; A R Chen; T J Walsh; P Szabolcs; M J Boeckh; J J Auletta; C A Lindemans; J Zanis-Neto; M Malvezzi; J Lister; J S de Toledo Codina; K Sackey; J L H Chakrabarty; P Ljungman; J R Wingard; M D Seftel; S Seo; G A Hale; B Wirk; M S Smith; B N Savani; H M Lazarus; D I Marks; C Ustun; H Abdel-Azim; C C Dvorak; J Szer; J Storek; A Yong; M R Riches Journal: Bone Marrow Transplant Date: 2016-01-04 Impact factor: 5.483
Authors: Arne Simon; Rhoikos Furtwängler; Norbert Graf; Hans Jürgen Laws; Sebastian Voigt; Brar Piening; Christine Geffers; Philipp Agyeman; Roland A Ammann Journal: GMS Hyg Infect Control Date: 2016-05-12
Authors: Alexandra Podpeskar; Roman Crazzolara; Gabriele Kropshofer; Petra Obexer; Evelyn Rabensteiner; Miriam Michel; Christina Salvador Journal: Front Pediatr Date: 2022-09-12 Impact factor: 3.569