Pneumocystis jirovecii infection in autologous hematopoietic stem cell transplantation

Area of Science:

• Hematology
• Infectious Diseases
• Oncology

Background:

• Pneumocystis jirovecii pneumonia (PJP) is a significant opportunistic infection following autologous stem cell transplantation (ASCT).
• Characterizing PJP incidence and risk factors post-ASCT is crucial for optimizing patient management and prophylaxis strategies.

Purpose of the Study:

• To investigate the incidence and risk factors of PJP in patients undergoing ASCT.
• To identify specific patient subgroups at higher risk for PJP development after ASCT.

Main Methods:

• Retrospective analysis of 304 ASCT recipients from 2005-2024.
• Evaluation of PJP incidence, timing, and associated risk factors, including disease type and prior treatments.

Main Results:

• Fourteen patients (4.6%) developed PJP, with a 1-year cumulative incidence of 5.2%.
• Follicular lymphoma (24%) and prior rituximab exposure (HR 6.75) were significantly associated with increased PJP risk.
• No deaths were directly attributed to PJP.

Conclusions:

• PJP risk after ASCT is diagnosis-dependent, with follicular lymphoma patients and those exposed to rituximab being at higher risk.
• Current prophylaxis strategies may be insufficient for certain high-risk groups.
• Further research is needed to determine optimal PJP prophylaxis duration and strategies in ASCT recipients.