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Prognostic impact of early adjunctive corticosteroid therapy in non-HIV oncology or haematology patients with Pneumocystis jirovecii pneumonia: A propensity score analysis

Assal, Mehdi ; Lambert, Jérôme ; Chow-Chine, Laurent ; Bisbal, Magali ; Servan, Luca ; Gonzalez, Frederic ; de Guibert, Jean Manuel ; Faucher, Marion ; Vey, Norbert ; Sannini, Antoine ; Mokart, Djamel Chen, Robert Jeenchen

PloS one, 2021-04, Vol.16 (4), p.e0250611-e0250611 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
Prognostic impact of early adjunctive corticosteroid therapy in non-HIV oncology or haematology patients with Pneumocystis jirovecii pneumonia: A propensity score analysis
Autor: Assal, Mehdi ; Lambert, Jérôme ; Chow-Chine, Laurent ; Bisbal, Magali ; Servan, Luca ; Gonzalez, Frederic ; de Guibert, Jean Manuel ; Faucher, Marion ; Vey, Norbert ; Sannini, Antoine ; Mokart, Djamel
Chen, Robert Jeenchen
Assuntos: Alveoli ; Aspergillosis ; Biology and Life Sciences ; Blood cancer ; Bronchus ; Cancer therapies ; Corticoids ; Corticosteroids ; Data analysis ; Drug therapy ; Dyspnea ; Fungi ; Hematology ; HIV ; Human immunodeficiency virus ; Hypersensitivity ; Immunocompromised hosts ; Infections ; Infectious diseases ; Intensive care ; Intubation ; Invasiveness ; Medical prognosis ; Medicine and Health Sciences ; Methodology ; Mortality ; Opportunist infection ; Patients ; Physiological aspects ; Pneumocystis carinii pneumonia ; Pneumonia ; Prognosis ; Public health ; Stem cells ; Testing ; Transplants & implants ; Viruses
É parte de: PloS one, 2021-04, Vol.16 (4), p.e0250611-e0250611
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Competing Interests: The authors have declared that no competing interests exist.
Descrição: While early adjunctive corticosteroid therapy (EACST) has been proven effective in HIV patients with Pneumocystis Jirovecii Pneumonia (PJP), data remains controversial concerning non-HIV oncology or haematology patients. This retrospective study included cancer patients without HIV and with diagnosis of PJP admitted in a cancer referral centre, from January-1-2010 to March-31-2017. We compared 30-day and 1-year mortality rate, change in the respiratory item of the Sequential Organ Failure Assessment score(SOFA-resp worsening), use of tracheal intubation between day-1 and day-5 of anti-pneumocystis therapy and occurrence of coinfections between patients with EACST and those with no or late corticosteroid therapy, using an inverse probability weighting propensity score-based (IPW) analysis. 133 non-HIV oncology or haematology PJP patients were included (EACST n = 58, others n = 75). The main underlying conditions were haematological malignancies (n = 107, 80,5%), solid tumour (n = 27, 20,3%) and allogeneic stem cell transplantation (n = 17, 12,8%). Overall 30-day and 1-year mortality rate was 24,1% and 56,4%, respectively. IPW analysis found no difference on 30-day (HR = 1.45, 95% CI [0.7-3.04], p = 0.321) and 1-year (HR = 1.25, CI 95% [0.75-2.09], p = 0.39) mortality rate between groups. No difference in SOFA-resp worsening, tracheal intubation and coinfections was found between groups. Combination of EACST with anti-pneumocystis therapy in non-HIV onco-haematology PJP-patients was not associated with clinical improvement.
Editor: United States: Public Library of Science
Idioma: Inglês

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Prognostic impact of early adjunctive corticosteroid therapy in non-HIV oncology or haematology patients with Pneumocystis jirovecii pneumonia: A propensity score analysis

Assal, Mehdi ; Lambert, Jérôme ; Chow-Chine, Laurent ; Bisbal, Magali ; Servan, Luca ; Gonzalez, Frederic ; de Guibert, Jean Manuel ; Faucher, Marion ; Vey, Norbert ; Sannini, Antoine ; Mokart, Djamel Chen, Robert Jeenchen

United States: Public Library of Science

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