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- Title
Excess prevalence of Pneumocystis carinii pneumonia in patients treated for lymphoma with combination chemotherapy.
- Authors
Browne, Marcia J.; Hubbard, Susan M.; Longo, Dan L.; Fisher, Richard; Wesley, Robert; Ihde, Daniel C.; Young, Robert C.; Pizzo, Philip A.; Browne, M J; Hubbard, S M; Longo, D L; Fisher, R; Wesley, R; Ihde, D C; Young, R C; Pizzo, P A
- Abstract
A significantly greater prevalence of interstitial pulmonary infiltrates and Pneumocystis carinii pneumonitis occurred on one arm of a randomized study comparing ProMACE-CytaBOM (prednisone, methotrexate with leucovorin, doxorubicin, cyclophosphamide, etoposide; cytarabine, bleomycin, vincristine, methotrexate with leucovorin) to ProMACE-MOPP (ProMACE, mechlorethamine, vincristine, prednisone, procarbazine) chemotherapy in patients with lymphoma. Of the 37 patients receiving ProMACE-CytaBOM, 13 (35.1%) developed an interstitial pulmonary infiltrate compared with 3 of 32 (9.4%) patients receiving ProMACE-MOPP (p2 = 0.02). Of the 13 patients receiving ProMACE-CytaBOM who had infiltrates, open lung biopsy in 7 showed P. carinii; 5 others had clinically suspected P. carinii pneumonia, and 1 had blastomycosis. No patient receiving ProMACE-MOPP had documented or suspected P. carinii pneumonia. Of patients with infiltrates, 3 of 13 on ProMACE-CytaBOM but 0 of 3 on ProMACE-MOPP died. Two other patients on ProMACE-CytaBOM who had P. carinii pneumonia died. Groups did not differ in predisposing risk factors or patient history. The exact cause for the increased prevalence of P. carinii infection in patients receiving ProMACE-CytaBOM was not ascertained. These data emphasize that new drug regimens may lead to unanticipated complications.
- Subjects
PNEUMOCYSTIS pneumonia; LYMPHOMAS; COMBINATION drug therapy; ANTINEOPLASTIC agents; B cell lymphoma; CLINICAL trials; COMPARATIVE studies; DRUG administration; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; RESEARCH; STATISTICAL sampling; EVALUATION research; RANDOMIZED controlled trials
- Publication
Annals of Internal Medicine, 1986, Vol 104, Issue 3, p338
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-104-3-338