Table 2.
Premorbid immunosuppression, chemotherapy and corticosteroid exposure among 297 patients with positive PCR for P. jirovecii
| Immunosuppression/chemotherapy regimens at presentation, n (%) | |
| Chemotherapy for hematological malignancy with adjuvant corticosteroids | 67 (22.6) |
| Corticosteroids in monotherapy | 44 (14.8) |
| Graft rejection prophylaxis after solid organ transplantation | 36 (12.1) |
| Chemotherapy for solid malignancy with adjuvant corticosteroids | 33 (11.1) |
| DMARDs with adjuvant corticosteroids | 22 (7.4) |
| Chemotherapy for solid malignancy | 16 (5.4) |
| Chemotherapy for hematological malignancy | 12 (4.0) |
| Corticosteroids and other immunosuppressantsa | 8 (2.7) |
| DMARDs in monotherapy | 5 (1.7) |
| Prophylaxis or treatment for GVHD after allogenic stem cell transplantation | 3 (1.0) |
| Other combinationsb | 2 (0.7) |
| None | 49 (16.5) |
| Systemic corticosteroid exposure last 60 days prior to presentation, n (%) | |
| Daily | 125 (42.1) |
| Intermittent | 91 (30.6) |
| No exposure to systemic corticosteroids | 79 (26.6) |
| No information | 2 (0.7) |
| Corticosteroid daily dosage in mg methylprednisolone at presentation, n = 292 | |
| Median the day of P. jirovecii detection (q1-q3), n = 146 | 8 (4–20) |
| Minimum, maximum | 0,120 |
| Indications for corticosteroid administration among exposedc, n (%) | |
| Immunosuppression for immunological disorders or graft rejection prophylaxis | 99 (46.3) |
| Chemotherapy | 75 (35.0) |
| Anti-emesis and other oncological indicationsd | 51 (23.8) |
| Peritumoral oedema in primary and secondary intracranial tumors | 16 (7.5) |
| Hematological and solid malignancies complicated by AIHA or ITP | 9 (4.2) |
Abbreviations: AIHA autoimmune hemolytic anemia, DMARDs disease-modifying anti-rheumatic drugs, GVHD graft-versus-host disease, ITP immune thrombocytopenic purpura
aOther immunosuppressants include mycophenolate, azathioprine, cyclophosphamide, calcineurin- and mTOR-inhibitors, cyclosporine and hydroxychloroquine
bOther combinations of immunosuppressive regimens include one patient receiving graft rejection prophylaxis for solid organ transplantation in combination with chemotherapy for hematological malignancy with adjuvant corticosteroids and one patient receiving azathioprine for vasculitis, respectively
c214 patients (72.1%) had known exposure to systemic corticosteroids last 60 days prior to presentation, and proportions are expressed with 214 as denominator. In some cases, corticosteroids were prescribed for more than one indication
dOther oncological indications include peritumoral oedema for patients with extracranial tumors, corticosteroids in combination with radiotherapy, vena cava superior syndrome, medulla compression etc.