Increased incidence of interstitial pneumonia by CHOP combined with rituximab

Daisuke Ennishi, Yasuhito Terui, Masahiro Yokoyama, Yuko Mishima, Shunji Takahashi, Kengo Takeuchi, Kazuma Ikeda, Mitsune Tanimoto, Kiyohiko Hatake

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

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 β-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.

Original languageEnglish
Pages (from-to)393-397
Number of pages5
JournalInternational Journal of Hematology
Volume87
Issue number4
DOIs
Publication statusPublished - May 2008

Fingerprint

Interstitial Lung Diseases
Incidence
Pneumocystis carinii
Sulfamethoxazole Drug Combination Trimethoprim
Pneumocystis Pneumonia
Glucans
Mycoses
Vincristine
Therapeutics
Prednisone
Rituximab
Sputum
Candida albicans
Doxorubicin
Cyclophosphamide
Pneumonia
Randomized Controlled Trials
Steroids
Polymerase Chain Reaction
Serum

Keywords

  • β-D-glucan
  • Interstitial pneumonia
  • R-CHOP
  • Rituximab

ASJC Scopus subject areas

  • Hematology

Cite this

Ennishi, D., Terui, Y., Yokoyama, M., Mishima, Y., Takahashi, S., Takeuchi, K., ... Hatake, K. (2008). Increased incidence of interstitial pneumonia by CHOP combined with rituximab. International Journal of Hematology, 87(4), 393-397. https://doi.org/10.1007/s12185-008-0066-7

Increased incidence of interstitial pneumonia by CHOP combined with rituximab. / Ennishi, Daisuke; Terui, Yasuhito; Yokoyama, Masahiro; Mishima, Yuko; Takahashi, Shunji; Takeuchi, Kengo; Ikeda, Kazuma; Tanimoto, Mitsune; Hatake, Kiyohiko.

In: International Journal of Hematology, Vol. 87, No. 4, 05.2008, p. 393-397.

Research output: Contribution to journalArticle

Ennishi, D, Terui, Y, Yokoyama, M, Mishima, Y, Takahashi, S, Takeuchi, K, Ikeda, K, Tanimoto, M & Hatake, K 2008, 'Increased incidence of interstitial pneumonia by CHOP combined with rituximab', International Journal of Hematology, vol. 87, no. 4, pp. 393-397. https://doi.org/10.1007/s12185-008-0066-7
Ennishi, Daisuke ; Terui, Yasuhito ; Yokoyama, Masahiro ; Mishima, Yuko ; Takahashi, Shunji ; Takeuchi, Kengo ; Ikeda, Kazuma ; Tanimoto, Mitsune ; Hatake, Kiyohiko. / Increased incidence of interstitial pneumonia by CHOP combined with rituximab. In: International Journal of Hematology. 2008 ; Vol. 87, No. 4. pp. 393-397.
@article{875ff3f799c64cee978224961c24d6a8,
title = "Increased incidence of interstitial pneumonia by CHOP combined with rituximab",
abstract = "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 β-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.",
keywords = "β-D-glucan, Interstitial pneumonia, R-CHOP, Rituximab",
author = "Daisuke Ennishi and Yasuhito Terui and Masahiro Yokoyama and Yuko Mishima and Shunji Takahashi and Kengo Takeuchi and Kazuma Ikeda and Mitsune Tanimoto and Kiyohiko Hatake",
year = "2008",
month = "5",
doi = "10.1007/s12185-008-0066-7",
language = "English",
volume = "87",
pages = "393--397",
journal = "International Journal of Hematology",
issn = "0925-5710",
publisher = "Springer Japan",
number = "4",

}

TY - JOUR

T1 - Increased incidence of interstitial pneumonia by CHOP combined with rituximab

AU - Ennishi, Daisuke

AU - Terui, Yasuhito

AU - Yokoyama, Masahiro

AU - Mishima, Yuko

AU - Takahashi, Shunji

AU - Takeuchi, Kengo

AU - Ikeda, Kazuma

AU - Tanimoto, Mitsune

AU - Hatake, Kiyohiko

PY - 2008/5

Y1 - 2008/5

N2 - 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 β-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.

AB - 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 β-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.

KW - β-D-glucan

KW - Interstitial pneumonia

KW - R-CHOP

KW - Rituximab

UR - http://www.scopus.com/inward/record.url?scp=46149108572&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=46149108572&partnerID=8YFLogxK

U2 - 10.1007/s12185-008-0066-7

DO - 10.1007/s12185-008-0066-7

M3 - Article

C2 - 18409079

AN - SCOPUS:46149108572

VL - 87

SP - 393

EP - 397

JO - International Journal of Hematology

JF - International Journal of Hematology

SN - 0925-5710

IS - 4

ER -