{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T16:21:24Z","timestamp":1770481284839,"version":"3.49.0"},"reference-count":92,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2006,7,11]],"date-time":"2006-07-11T00:00:00Z","timestamp":1152576000000},"content-version":"vor","delay-in-days":4058,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[1995,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The high incidence of opportunistic pulmonary infections in fludarabine\u2010treated patients at Walter Reed Army Medical Center (WRAMC) and in the literature are described. A CancerLlt search of fludarabine from June 1983\u2010April 1994 with subsequent cross referencing and a retrospective review of all patients receiving fludarabine at WRAMC was performed. A total of 2,269 patients with low\u2010grade lymphoid malignancies who received 7,547 + cycles of fludarabine were identified from the literature. Seventy\u2010three (3.2%) of these patients developed opportunistic infections. Seventy\u2010one (97%) of these infections occurred in patients who were pretreated with alkylator regimens or corticosteroids. Forty\u2010five (2%) of these were of respiratory origin and associated with a 56% mortality rate. In contrast, 6 of the 21 patients (29%) treated with fludarabine at WRAMC developed opportunistic pulmonary infections which included three <jats:italic>Pneumocystis carinii<\/jats:italic> (PCP), one PCP\/disseminated Candidiasis, one <jats:italic>Mycobacterium avium intracellulare<\/jats:italic>, and one <jats:italic>Aspergillus niger<\/jats:italic> pneumonia. These infections developed during and after treatment with fludarabine in alkylator\u2010resistant patients who had received corticosteroids before (n = 6), during (n = 1), or after (n = 4) fludarabine therapy. Lack of PCP prophylaxis was the only significant (<jats:italic>P<\/jats:italic> = .018) variable that differentiated patients who developed opportunistic pulmonary infections. Corticosteroid treatment before, during, or after fludarabine treatment in patients with alkylator\u2010resistant, low\u2010grade lymphoid malignancies who have not received PCP prophylaxis is associated with an increased risk of opportunistic pulmonary infections. Aggressive work\u2010up of pulmonary syndromes and PCP prophylaxis in these patients should be considered during and after treatment with fludarabine. \u00a9 1995 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ajh.2830490207","type":"journal-article","created":{"date-parts":[[2007,2,21]],"date-time":"2007-02-21T13:54:07Z","timestamp":1172066047000},"page":"135-142","source":"Crossref","is-referenced-by-count":82,"title":["Opportunistic pulmonary infections with fludarabine in previously treated patients with low\u2010grade lymphoid malignancies: A role for pneumocystis carinii pneumonia prophylaxis"],"prefix":"10.1002","volume":"49","author":[{"given":"John C.","family":"Byrd","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey B.","family":"Hargis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kent 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