Evidence map›Paper›PMID 34155819›Full record

Observational studyCancer medicine2021

Incidence of Pneumocystis jirovecii pneumonia utilizing a polymerase chain reaction-based diagnosis in patients receiving bendamustine.

Mikhaila L Rice, Jason N Barreto, Carrie A Thompson, Kristin C Mara, Pritish K Tosh, Andrew H Limper

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in Cancer medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Mikhaila L RiceDepartment of Pharmacy, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0002-4273-5780
Jason N BarretoDepartment of Pharmacy, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0003-2146-5766
Carrie A ThompsonDivision of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0002-4518-2309
Kristin C MaraDivision of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0002-8783-0191
Pritish K ToshDivision of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0002-7518-3329
Andrew H LimperDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0001-5671-6874
Mayo Clinic in Arizona · USMayo Clinic in Florida · US

Funding

Pneumocystis: Macrophage & Epithelial ActivationR01HL062150 · NHLBI · MAYO CLINIC ROCHESTER · PI ANDREW H LIMPER · 1998 to 2026
$9.2M
NRSA Training CoreTL1TR002380 · NCATS · MAYO CLINIC ROCHESTER · PI Felicity T. B. Enders, ANTHONY John WINDEBANK · 2017 to 2026
$6.0M
NCATS NIH HHS TL1 TR002380NHLBI NIH HHS R01 HL062150
6 · The paper itself

Abstract

backgroundPneumocystis jirovecii pneumonia (PJP) is a life-threatening infection occurring in patients receiving bendamustine. The poorly defined incidence, particularly when utilizing polymerase chain reaction (PCR)-based diagnostic techniques, precipitates unclear prophylaxis recommendations. Our objective was to determine the cumulative incidence of PJP diagnosed by single copy target, non-nested PCR in patients receiving bendamustine.

methodsPatients were evaluated for PJP from initiation of bendamustine through 9 months after the last administration. The cumulative incidence of PJP was estimated using the Aalen-Johansen method. Cox proportional hazard models were used to demonstrate the strength of association between the independent variables and PJP risk.

resultsThis single-center, retrospective cohort included 486 adult patients receiving bendamustine from 1 January 2006 through 1 August 2019. Most patients received bendamustine-based combination therapy (n = 461, 94.9%), and 225 (46.3%) patients completed six cycles. Rituximab was the most common concurrent agent (n = 431, 88.7%). The cumulative incidence of PJP was 1.7% (95% CI 0.8%-3.3%, at maximum follow-up of 2.5 years), after the start of bendamustine (n = 8 PJP events overall). Prior stem cell transplant, prior chemotherapy within 1 year of bendamustine, and lack of concurrent chemotherapy were associated with the development of PJP in univariate analyses. Anti-Pneumocystis prophylaxis was not significantly associated with a reduction in PJP compared to no prophylaxis (HR 0.37, 95% CI (0.05, 3.04), p = 0.36).

conclusionsOur incidence of PJP below 3.5%, the conventional threshold for prophylaxis implementation, indicates routine anti-Pneumocystis prophylaxis may not be necessary in this population. Factors indicating a high-risk population for targeted prophylaxis require further investigation.

Indexed as

Pneumocystis cariniiAdultAgedAged, 80 and overAntifungal AgentsAntineoplastic Agents, AlkylatingAntineoplastic Agents, ImmunologicalBendamustine HydrochlorideFemaleHumansIncidenceLymphoma, FollicularMaleMiddle AgedPneumonia, PneumocystisPolymerase Chain ReactionAntifungal AgentsAntineoplastic Agents, AlkylatingAntineoplastic Agents, ImmunologicalBendamustine HydrochlorideRituximabchemotherapyclinical managementhematological cancerlymphoma

Identifiers

PMID34155819
PMCPMC8335812
OpenAlexW3174588124

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.