Pentamidine aerosol for prophylaxis of Pneumocystis carinii pneumonia after BMT.
Following BMT there is a 5-15% risk of interstitial pneumonia caused by Pneumocystis carinii (PcP). Cotrimoxazole is therefore administered prophylactically, but may cause myelodepression, allergic reactions and nephrotoxicity. As PcP prophylaxis with pentamidine aerosol is effective in patients with AIDS, we conducted a prospective trial with regular inhalations of pentamidine. The aim of this study was to evaluate toxicity, safety, practicability and possible resorption of aerosolized pentamidine. We treated 31 allogeneic and 12 autologous BMT patients with 60 mg pentamidine 3 days before and 14 days after BMT. Starting 4 weeks after BMT, 300 mg pentamidine was given every 4 weeks for 6 months. There was no pneumonia caused by Pneumocystis carinii. The only noteworthy side-effects were cough (19.8%), salivation (9.6%), and sore throat (5.7%), of similar frequency after allogeneic or autologous BMT. Using high pressure liquid chromatography, pentamidine could only be detected in the serum of 33-54% of patients tested. In these patients the median serum levels were 7.5-9 ng/ml. We conclude that pentamidine aerosol has only minor side-effects, is well tolerated and safe, and is therefore an attractive alternative for PcP prophylaxis after BMT.
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Department of Haematology and Oncology, Medizinische Hochschule, Hannover, Germany.
Vöhringer
H F
HF
Wingen
F
F
Brägas
B
B
Schwardt
A
A
Ehninger
G
G
D000280:Administration, Inhalation; D000328:Adult; D016026:Bone Marrow Transplantation; D005260:Female; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D007938:Leukemia / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010419:Pentamidine / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000652:urine; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control*; D011446:Prospective Studies
D010419:Pentamidine