Pneumocystis jiroveci (PJP) is a severe, opportunistic infection that remains a potential burden in patients who are immunocompromised. Patients who undergo treatment with brentuximab vedotin (BV) may be at risk for this infection due to the CD30-targeted effects of the drug antibody conjugate. Thus, PJP prophylaxis may need to be considered. However, few studies have assessed the frequency of PJP following the administration of BV.
This study, published in the Journal of Clinical Oncology for the 2022 ASCO Annual Meeting, investigated the development of PJP within 3 months in patients receiving BV. Patients were evaluated between January 2011 and October 2021 at Mayo Clinic for the development of PJP. Data collected included patient demographics and clinical characteristics, including underlying disease, chemotherapy regimen, steroid use, and absolute lymphocyte count (ALC).
A total of 339 BV recipients who had not previously received PJP prophylaxis were included in the study. Patients received treatment regimens that included BV monotherapy, BV-CHP, or BV-AVD. Ultimately, it was found that around 4% of patients receiving BV developed PJP. Patients with PJP had a median ALC of 620, with steroid exposure before PJP seen in 21% of patients with a median exposure of 8 days. At the time of PJP diagnosis, 71.4% were older than 50.
In conclusion, a rate of 4% of patients developing PJP after BV therapy, which is above the 3.5% threshold for recommending prophylaxis, calls for the use of PJP prophylaxis. Healthcare providers should closely monitor ALC in patients receiving BV and establish the use of PJP prophylaxis as needed, especially in patients older than 50 [1].
Source:
[1] Scheckel, C., Abeykoon, J. P., Childs, D. S., Higgins, A., Hwang, S. R., Barreto, J., Ansell, S. M., & Bennani, N. N. (2022, May). PJP pneumonia in brentuximab vedotin recipients. 2022 ASCO Annual Meeting, Chicago, IL. https://meetings.asco.org/abstracts-presentations/209269
