Abstract
There are a few reports suggesting that rituximab (RTX) might be a risk for interstitial pneumonitis (IP). We also experienced such patients in the era of RTX. Here, we reviewed all the patients with non-Hodgkin lymphoma who were treated with RTX-CHOP-like regimen (R-CHOP) to determine the risk of developing IP. One of 59 (1.7%) patients who received CHOP alone and 8 of 129 (6.2%) patients who were treated with R-CHOP experienced IP (p = 0.28). Furthermore, three of eight patients who have had IP during R-CHOP were confirmed having Pneumocystis jirovecii pneumonia (PCP). PCP occurred during the fourth, sixth, and seventh cycle of chemotherapy, respectively. Among the patients treated by R-CHOP, 3 of 32 (9%) patients whose lymphocyte counts were <1000/microL before chemotherapy developed PCP, while 70 patients whose lymphocyte counts were >1000/microL did not (p = 0.03). In four of eight patients, IP occurred during the administration of granulocyte-colony stimulating factor. RTX seems to have a certain risk to induce IP including PCP. Patients with lymphoma who were treated by R-CHOP regimen, might be considered as PCP prophylactic, especially if the number of lymphocytes is low at the beginning of chemotherapy.
MeSH terms
-
Adult
-
Aged
-
Antibodies, Monoclonal / administration & dosage
-
Antibodies, Monoclonal / adverse effects
-
Antibodies, Monoclonal, Murine-Derived
-
Antineoplastic Combined Chemotherapy Protocols / adverse effects*
-
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
-
Cyclophosphamide / administration & dosage
-
Cyclophosphamide / adverse effects
-
DNA, Fungal / genetics
-
Doxorubicin / administration & dosage
-
Doxorubicin / adverse effects
-
Female
-
Granulocyte Colony-Stimulating Factor / administration & dosage
-
Granulocyte Colony-Stimulating Factor / adverse effects
-
Humans
-
Lung Diseases, Interstitial / chemically induced*
-
Lung Diseases, Interstitial / diagnosis
-
Lung Diseases, Interstitial / microbiology
-
Lymphocyte Count
-
Lymphoma, Non-Hodgkin / drug therapy*
-
Male
-
Middle Aged
-
Pneumocystis carinii / genetics
-
Pneumocystis carinii / isolation & purification
-
Polymerase Chain Reaction
-
Prednisolone / administration & dosage
-
Prednisolone / adverse effects
-
Retrospective Studies
-
Risk Assessment
-
Rituximab
-
Vincristine / administration & dosage
-
Vincristine / adverse effects
Substances
-
Antibodies, Monoclonal
-
Antibodies, Monoclonal, Murine-Derived
-
DNA, Fungal
-
Granulocyte Colony-Stimulating Factor
-
Rituximab
-
Vincristine
-
Doxorubicin
-
Cyclophosphamide
-
Prednisolone