title: Incidence of Pneumocystis jirovecii pneumonia after temozolomide for CNS malignancies without prophylaxis.
abstract: OBJECTIVE
  Prophylaxis against Pneumocystis jiroveci pneumonia (PJP) is currently recommended for patients receiving chemoradiation with temozolomide for newly diagnosed glioblastoma multiforme. At our institution, PJP prophylaxis during temozolomide treatment has not been routinely given because of the paucity of supporting data. We investigated the rate of PJP infections in our patients.
  
  
  METHODS
  We conducted a retrospective chart review of 240 brain tumor patients treated between 1999 and 2012 with temozolomide and no PJP prophylaxis, 127 of which received concurrent chemoradiation.
  
  
  RESULTS
  One in 240 patients (0.4%; 95% CI: 0.01-2.00; median total dose: 7375 mg/m(2); interquartile range: 1300) were diagnosed with PJP.
  
  
  CONCLUSIONS
  There was a <1% rate of PJP for brain tumor patients treated with temozolomide until progression without PJP prophylaxis.
authors.affiliation: Department of Internal Medicine, University of New Mexico, 1 University of NM, Albuquerque, New Mexico 87131, USA.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Neuwelt
authors.forename: Tam M
authors.initials: TM
authors.lastname: Nguyen
authors.forename: Rongwei
authors.initials: R
authors.lastname: Fu
authors.forename: Joseph
authors.initials: J
authors.lastname: Bubalo
authors.forename: Rose Marie
authors.initials: RM
authors.lastname: Tyson
authors.forename: Cynthia
authors.initials: C
authors.lastname: Lacy
authors.forename: Seymur
authors.initials: S
authors.lastname: Gahramanov
authors.forename: Morad
authors.initials: M
authors.lastname: Nasseri
authors.forename: Penelope D
authors.initials: PD
authors.lastname: Barnes
authors.forename: Edward A
authors.initials: EA
authors.lastname: Neuwelt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects*; D001932:Brain Neoplasms / Q000188:drug therapy; D002648:Child; D003606:Dacarbazine / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000139:chemically induced* / Q000453:epidemiology*; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000473:pathology; D000077204:Temozolomide; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide
keywords: Pneumocystis jirovecii; brain radiation; glioblastoma; temozolomide