There is not much need for universal anti-Pneumocystis prophylaxis during R-CHOP treatment of B-cell lymphoma, since there is a low occurrence of Pneumocystis pneumonia, according to a study involving nearly 700 individuals.

Investigators looked at the incidence of Pneumocystis jirovecii pneumonia (PJP) infection, evaluating participants from start of chemotherapy until 180 days after the last administration. Among the results:

• ~Three-fourths finished at least 6 cycles of R-CHOP treatment.

• Median cumulative doses were 3,950 mg for rituximab and 5,325 mg for prednisone.

• Median prednisone dose through treatment end was 45 mg/day.

• Cumulative PJP incidence was 1.51%, which is below the conventional threshold for prophylaxis (3.5%).

• Univariate analysis did not reveal a significant link between PJP and rituximab, steroids, or receipt of additional chemotherapy.

Citation: Barreto J, Ice L, Thompson C, et al. Low incidence of pneumocystis pneumonia utilizing PCR-based diagnosis in patients with B-cell lymphoma receiving rituximab-containing combination chemotherapy. [Published online ahead of print August 22, 2016]. Am J Hematol. doi:10.1002/ajh.24499.