title: ECIL guidelines for preventing Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients.
abstract: The 5th European Conference on Infections in Leukaemia (ECIL-5) meeting aimed to establish evidence-based recommendations for the prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in non-HIV-infected patients with an underlying haematological condition, including allogeneic HSCT recipients. Recommendations were based on the grading system of the IDSA. Trimethoprim/sulfamethoxazole given 2-3 times weekly is the drug of choice for the primary prophylaxis of PCP in adults ( A-II: ) and children ( A-I: ) and should be given during the entire period at risk. Recent data indicate that children may benefit equally from a once-weekly regimen ( B-II: ). All other drugs, including pentamidine, atovaquone and dapsone, are considered second-line alternatives when trimethoprim/sulfamethoxazole is poorly tolerated or contraindicated. The main indications of PCP prophylaxis are ALL, allogeneic HSCT, treatment with alemtuzumab, fludarabine/cyclophosphamide/rituximab combinations, >4 weeks of treatment with corticosteroids and well-defined primary immune deficiencies in children. Additional indications are proposed depending on the treatment regimen.
authors.affiliation: Department of Haematology, Acute Leukaemia and Stem Cell Transplantation Unit, University Hospitals Leuven, Campus Gasthuisberg, Leuven, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Maertens
authors.affiliation: Department of Haematology, Oncoematologia Pediatrica, Policlinico G. B. Rossi, Verona, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Cesaro
authors.affiliation: Department of Haematology, Oncology and Palliative Care, Ernst-von-Bergmann Klinikum, Potsdam, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Maschmeyer
authors.affiliation: Department of Internal Medicine II, Julius Maximilians University, Würzburg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Einsele
authors.affiliation: Department of Haematology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: J Peter
authors.initials: JP
authors.lastname: Donnelly
authors.affiliation: Parasitology-Mycology Laboratory, Groupe Hospitalier Lariboisière Saint-Louis Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Diderot, Sorbonne Paris Cité, and Institut Pasteur, Unité de Mycologie Moléculaire, CNRS URA3012, Centre National de Référence Mycoses Invasives et Antifongiques, Paris, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Alanio
authors.affiliation: Institute of Microbiology, Lausanne University Hospital and University, Lausanne, Switzerland.
authors.forename: Philippe M
authors.initials: PM
authors.lastname: Hauser
authors.affiliation: Department of Microbiology and Immunology, KU Leuven-University of Leuven, Leuven, Belgium and National Reference Center for Mycosis, Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Katrien
authors.initials: K
authors.lastname: Lagrou
authors.affiliation: Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Willem J G
authors.initials: WJ
authors.lastname: Melchers
authors.affiliation: Department of Infectious Diseases, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Jannik
authors.initials: J
authors.lastname: Helweg-Larsen
authors.affiliation: Medical Parasitology Unit, Group of Opportunistic Protozoa/HIV and Other Protozoa, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisboa, Portugal.
authors.forename: Olga
authors.initials: O
authors.lastname: Matos
authors.affiliation: Parasitology-Mycology Laboratory, Groupe Hospitalier Lariboisière Saint-Louis Fernand Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Diderot, Sorbonne Paris Cité, and Institut Pasteur, Unité de Mycologie Moléculaire, CNRS URA3012, Centre National de Référence Mycoses Invasives et Antifongiques, Paris, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bretagne
authors.affiliation: Department of Haematology, Henri Mondor Teaching Hospital, Assistance Publique-Hôpitaux de Paris, and Université Paris-Est-Créteil, Créteil, France catherine.cordonnier@aphp.fr.
authors.forename: Catherine
authors.initials: C
authors.lastname: Cordonnier
mesh_terms: D000935:Antifungal Agents / Q000008:administration & dosage*; D018890:Chemoprevention / Q000379:methods*; D019337:Hematologic Neoplasms / Q000150:complications* / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control*; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D066027:Transplant Recipients; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage
chemical_list: D000935:Antifungal Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination