Table 2.

PJP cases

Age, y/sexPrior treatmentsTherapyIbrutinib duration at time of PJP, moSteroid use within preceding 30 dIgG level at time of infectionSymptomsDiagnostic testsPJP therapyOutcome
Chest CT scanβ-d-glucan level
Case 1           
 75/male None: randomized to ibrutinib-alone arm of phase 3 trial Ibrutinib single agent 1.1 None Data not available Fever, cough, dyspnea, fatigue Diffuse bilateral patchy ground-glass opacities 289 TMP-SMX + prednisone for 21 d; ibrutinib held Following PJP treatment, ibrutinib and PJP prophylaxis were resumed; symptoms resolved without subsequent recurrence of PJP 
Case 2           
 80/female F/FR/PCR Ibrutinib single agent 2.7 None 272 Fever, dyspnea, hypoxia (oxygen saturation 88% on room air) Diffuse bilateral patchy ground-glass opacities 171 TMP-SMX + prednisone for 21 d; ibrutinib held Following PJP treatment, ibrutinib and PJP prophylaxis were resumed; symptoms resolved without subsequent recurrence of PJP 
Case 3           
 62/female None: enrolled in clinical trial of frontline therapy iFCR 30.6 None 166 Fever, dyspnea, hypoxia (oxygen saturation 82% on room air) Diffuse bilateral patchy ground-glass opacities 394 TMP-SMX + prednisone for 21 d; ibrutinib held Following PJP treatment, ibrutinib and PJP prophylaxis were resumed; symptoms resolved without subsequent recurrence of PJP 
Age, y/sexPrior treatmentsTherapyIbrutinib duration at time of PJP, moSteroid use within preceding 30 dIgG level at time of infectionSymptomsDiagnostic testsPJP therapyOutcome
Chest CT scanβ-d-glucan level
Case 1           
 75/male None: randomized to ibrutinib-alone arm of phase 3 trial Ibrutinib single agent 1.1 None Data not available Fever, cough, dyspnea, fatigue Diffuse bilateral patchy ground-glass opacities 289 TMP-SMX + prednisone for 21 d; ibrutinib held Following PJP treatment, ibrutinib and PJP prophylaxis were resumed; symptoms resolved without subsequent recurrence of PJP 
Case 2           
 80/female F/FR/PCR Ibrutinib single agent 2.7 None 272 Fever, dyspnea, hypoxia (oxygen saturation 88% on room air) Diffuse bilateral patchy ground-glass opacities 171 TMP-SMX + prednisone for 21 d; ibrutinib held Following PJP treatment, ibrutinib and PJP prophylaxis were resumed; symptoms resolved without subsequent recurrence of PJP 
Case 3           
 62/female None: enrolled in clinical trial of frontline therapy iFCR 30.6 None 166 Fever, dyspnea, hypoxia (oxygen saturation 82% on room air) Diffuse bilateral patchy ground-glass opacities 394 TMP-SMX + prednisone for 21 d; ibrutinib held Following PJP treatment, ibrutinib and PJP prophylaxis were resumed; symptoms resolved without subsequent recurrence of PJP 

CT, computed tomography; F, fludarabine;  FCR, fludarabine, cyclophosphamide, rituximab; FR, fludarabine, rituximab; IgG, immunoglobulin G; PCR, pentostatin, cyclophosphamide, rituximab.

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