Pneumocystis jiroveci pneumonia prophylaxis during maintenance therapy influences methotrexate/6-mercaptopurine dosing but not event-free survival for childhood acute lymphoblastic leukemia

Mette Levinsen, Diana Shabaneh, Cathrine Bohnstedt, Arja Harila-Saari, Olafur G Jonsson, Jukka Kanerva, Anna Lindblom, Bendik Lund, Louise Elisabeth Andersen, Kjeld Schmiegelow, Nordic Society of Paediatric Haematology and Oncology (NOPHO)

22 Citationer (Scopus)

Abstract

Trimethoprim-sulfamethoxazole (TMP/SMX) is used in children with acute lymphoblastic leukemia (ALL) to prevent Pneumocystis pneumonia (PCP). We explored to which extent TMP/SMX influenced methotrexate (MTX)/6-mercaptopurine (6MP) dosage, myelosuppression, and event-free survival (EFS) during maintenance therapy. Of 447 study patients treated by the NOPHO ALL92 protocol, 120 patients received TMP/SMX continuously for 2-7 d/wk (TMP/SMX(2-7) ) and 287 patients never received TMP/SMX (TMP/SMX(never) ). Ten patients (all TMP/SMX(never) ) developed PCP, eight of which occurred within 7 months from the start of maintenance therapy. The TMP/SMX(2-7) group received lower oral 6MP doses than TMP/SMX(never) patients (50.6 vs. 63.9 mg/m(2) /d; P
OriginalsprogEngelsk
TidsskriftEuropean Journal of Haematology
Vol/bind88
Udgave nummer1
Sider (fra-til)78-86
Antal sider9
ISSN0902-4441
DOI
StatusUdgivet - 2012

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