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Background <p><i>Pneumocystis jirovecii</i> pneumonia (PJP) is a fatal opportunistic infectious disease. We conducted this study to describe the clinical characteristics and explore the prognostic factors of patients with concurrent malignancies and PJP (malignancy-PJP).</p> Methods <p>We retrospectively enrolled consecutive patients with malignancies diagnosed with PJP in our center from January 2014 to December 2022. The participants were classified into a hematological malignancy group and a non-hematological malignancy group. Cox regression models were used to analyze prognostic factors.</p> Results <p>Fifty-six malignancy-PJP patients were enrolled in our study with an average age of 63 (52, 68) years, 60.7% of whom were males. There were 33 (58.9%) hematological malignancy patients and 23 (41.1%) non-hematological malignancy patients. Overall, 29 (51.8%) patients died. Compared with the non-hematological malignancy group, more patients received mechanical ventilation (<i>p</i> = 0.03) in the hematological malignancy group. Moreover, shorter periods from the onset of underlying malignancies (<i>p</i> &lt; 0.01) and from the first dosage of chemotherapy (<i>p</i> = 0.04) to PJP infection were significantly more common in patients with hematological malignancies. However, patients with non-hematological malignancies presented more pleural thickening (<i>p</i> = 0.03) on chest computed tomography (CT). Multivariate analysis revealed that non-solid malignancies (HR = 2.77, <i>p</i> = 0.03, 95% CI: 1.12–6.89), cytomegalovirus (CMV) viremia (HR = 3.33, <i>p</i> &lt; 0.01, 95% CI: 1.51–7.33), bacterial hospital-acquired pneumonia (HAP) (HR = 2.21, <i>p</i> = 0.04, 95% CI: 1.03–4.77), and pneumomediastinum (HR = 2.50, <i>p</i> &lt; 0.05, 95% CI: 1.01–6.14) were independent risk factors for survival in malignancy-PJP patients.</p> Conclusions <p>Compared with patients with non-hematological malignancies, patients with hematological malignancies were more likely to require mechanical ventilation and to be infected with PJP within a shorter time from the onset of underlying malignancies and from the first chemotherapy treatment. Non-solid malignancies, CMV viremia, bacterial HAP, and pneumomediastinum were independent risk factors for survival in patients with malignancy-PJP.</p>

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Clinical characteristics and prognostic analysis of concurrent Pneumocystis jirovecii pneumonia in patients with malignancies: a retrospective study

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  • 发表日期：

    2025年10月27日

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  • Yujie Shi,
  • Ruxuan Chen,
  • Kai Xu,
  • Chi Shao,
  • Yongjian Liu,
  • Hui Huang

摘要

Background

Pneumocystis jirovecii pneumonia (PJP) is a fatal opportunistic infectious disease. We conducted this study to describe the clinical characteristics and explore the prognostic factors of patients with concurrent malignancies and PJP (malignancy-PJP).

Methods

We retrospectively enrolled consecutive patients with malignancies diagnosed with PJP in our center from January 2014 to December 2022. The participants were classified into a hematological malignancy group and a non-hematological malignancy group. Cox regression models were used to analyze prognostic factors.

Results

Fifty-six malignancy-PJP patients were enrolled in our study with an average age of 63 (52, 68) years, 60.7% of whom were males. There were 33 (58.9%) hematological malignancy patients and 23 (41.1%) non-hematological malignancy patients. Overall, 29 (51.8%) patients died. Compared with the non-hematological malignancy group, more patients received mechanical ventilation (p = 0.03) in the hematological malignancy group. Moreover, shorter periods from the onset of underlying malignancies (p < 0.01) and from the first dosage of chemotherapy (p = 0.04) to PJP infection were significantly more common in patients with hematological malignancies. However, patients with non-hematological malignancies presented more pleural thickening (p = 0.03) on chest computed tomography (CT). Multivariate analysis revealed that non-solid malignancies (HR = 2.77, p = 0.03, 95% CI: 1.12–6.89), cytomegalovirus (CMV) viremia (HR = 3.33, p < 0.01, 95% CI: 1.51–7.33), bacterial hospital-acquired pneumonia (HAP) (HR = 2.21, p = 0.04, 95% CI: 1.03–4.77), and pneumomediastinum (HR = 2.50, p < 0.05, 95% CI: 1.01–6.14) were independent risk factors for survival in malignancy-PJP patients.

Conclusions

Compared with patients with non-hematological malignancies, patients with hematological malignancies were more likely to require mechanical ventilation and to be infected with PJP within a shorter time from the onset of underlying malignancies and from the first chemotherapy treatment. Non-solid malignancies, CMV viremia, bacterial HAP, and pneumomediastinum were independent risk factors for survival in patients with malignancy-PJP.