Clinical Analysis of 15 Cases of Non-Hodgkin Lymphoma Complicated with Pneumocystis carinii Pneumonia Treated with R-CHOP Regimen

Abstract

Objective: To investigate the clinical features of R-CHOP regimen in the treatment of non-Hodgkin’s lymphoma with Pneumocystis carinii pneumonia (PCP) in order to improve the understanding of PCP and the side effects of Rituxan. Methods: A retrospective analysis of 90 patients with non-Hodgkin’s lymphoma treated with R-CHOP chemotherapy in our hospital from November 2015 to November 2020, of which 15 (16.7%) patients, combined with PCP clinical data, including clinical symptoms, physical signs, chest imaging examination and treatment data were used for to analysis and summarization. Results: The clinical features of R-CHOP chemotherapy combined with PCP were fever, cough, and sputum. Some patients had fewer clinical symptoms. Common imaging manifestations were double lung membrane glass shadow, patchy shadow, and flocculent shadow. It can occur in all clinical stages, and the incidence of late stage is high, and there is no clear correlation with bone marrow suppression. Pneumocystis was found in 2 cases of sputum, and the rest of the patients were clinically diagnosed. The main therapeutic drugs are sulfamethoxazole (8/15), compound sulfamethoxazole (6/15), clindamycin (1/15, sulfa drug allergy), and adrenal cortex hormones (4/15). Fourteen cases were cured and 1 case died. Conclusion: The incidence of R-CHOP in advanced non-Hodgkin’s lymphoma of PCP is high. Patients with clinical use of R-CHOP chemotherapy will encounter fever, cough, chest computed tomography (CT) film glass shadow, and diffuse patch shadow. Patients should be alert to the possibility of PCP and take sulfonamides as soon as possible for medical treatment.