Pneumocystis carinii pneumonia as a complication of bendamustine monotherapy in a patient with advanced progressive breast cancer

Journal of Cancer Research and Clinical Oncology
A KlippsteinK Höffken

Abstract

Bendamustine is an alkylator with anticipated antimetabolic activity. It has shown activity in malignant lymphoma, multiple myeloma, and breast cancer. Recognized side-effects are relatively mild with myelosuppression as the dose-limiting toxicity. The CD4/CD8 ratio may be reduced. To what extent the alteration of lymphocytes, especially CD4(+) lymphocytes, correlates with an increase in opportunistic infections cannot be definitively answered. The patient, female, aged 48 years, was suffering from an advanced progressive breast cancer. After initial treatment with several chemotherapies, a cytotoxic therapy was initiated, with bendamustine (150 mg/m(2)) administered on two consecutive days and repeated every 4 weeks. After five courses, the patient developed Pneumocystis carinii pneumonia (PCP), disclosed in the bronchoalveolar lavage. While receiving bendamustine therapy, the CD4(+) and CD8(+) lymphocyte counts in the peripheral blood were determined by flow cytometry. The next-to-normal CD4/CD8 ratio before therapy (0,82) had decreased to 0,05 during the therapy mainly due to a decline of CD4(+) lymphocyte. The patient was seronegative for human immunodeficiency virus. In spite of high-dose intravenous trimethoprim/sulfameth...Continue Reading

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Citations

Apr 30, 2013·Emerging Infectious Diseases·Rishma MainiNick Phin
Jul 30, 2005·Scandinavian Journal of Infectious Diseases·Donato TorrePiero Rapazzini
Jul 4, 2007·Transplant Infectious Disease : an Official Journal of the Transplantation Society·D Bandt, S Monecke
Apr 19, 2011·Expert Review of Hematology·Leslie A Andritsos, Michael R Grever
Oct 12, 2011·Current Opinion in Infectious Diseases·Alistair B ReidLeon J Worth
Mar 16, 2012·International Journal of Hematology·Yutaka TsutsumiMasahiro Imamura
Jun 12, 2012·International Journal of Hematology·Sean WarschIzidore S Lossos
Jun 14, 2013·Case Reports in Oncological Medicine·Tsuyoshi ShinoharaKiyofumi Yamagishi
Dec 24, 2015·Leukemia & Lymphoma·Anat Gafter-Gvili, Aaron Polliack
Sep 14, 2012·Expert Opinion on Drug Metabolism & Toxicology·Anna Korycka-Wołowiec, Tadeusz Robak
Mar 15, 2005·Scandinavian Journal of Infectious Diseases·France RoblotFrancois Guilhot

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