{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T19:35:14Z","timestamp":1793907314793,"version":"4.8.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,10,13]],"date-time":"2024-10-13T00:00:00Z","timestamp":1728777600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,10,13]],"date-time":"2024-10-13T00:00:00Z","timestamp":1728777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China,China","doi-asserted-by":"crossref","award":["81800178"],"award-info":[{"award-number":["81800178"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81730008"],"award-info":[{"award-number":["81730008"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82270234"],"award-info":[{"award-number":["82270234"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2304505"],"award-info":[{"award-number":["2022YFC2304505"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Pneumocystis jirovecii<\/jats:italic>\n                      pneumonia (PcP) is an opportunistic infection associated with immunocompromised patients. The development of novel immunotherapies has promoted the incidence of PcP. This study describes the clinical course and outcome of PcP in chimeric antigen receptor (CAR) T cell recipients with hematological malignancies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective case series of CAR-T recipients diagnosed with PcP in our center. The cases were all confirmed by metagenomic next-generation sequencing of clinical samples. The demographic, clinical, and outcome data were retrieved from the patients\u2019 medical charts and electronic medical record system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 8 cases of PcP were identified. The underlying malignancies included T-acute lymphoblastic leukemia (ALL) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091), diffuse large B cell lymphoma (DLBCL) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094), and B-ALL (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093). One patient received short-term sulfamethoxazole-trimethoprim (SMZ-TMP) while the others had no prophylaxis. Four patients had neutropenia\/lymphopenia at the diagnosis of PcP, and two patients had immunosuppressants within one month before PcP manifestation. The median time from CAR-T infusion to PcP diagnosis was 98.5\u00a0days (range 52\u2013251). Seven patients recovered from PcP after proper management while one died of septic shock.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PcP can occur after different CAR-T product, and the long-term depletion of immune cells seems to be related to PcP. SMZ-TMP is effective in this setting. More real-world experience of CAR-T therapy is required to assess the incidence and outcome of PcP in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-024-09893-x","type":"journal-article","created":{"date-parts":[[2024,10,13]],"date-time":"2024-10-13T08:01:34Z","timestamp":1728806494000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Outcome of Pneumocystis Jirovecii pneumonia (PcP) in post-CAR-T patients with hematological malignancies"],"prefix":"10.1186","volume":"24","author":[{"given":"Cheng","family":"Zu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxiao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingming","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yetian","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruimin","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongxian","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junwei","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,13]]},"reference":[{"key":"9893_CR1","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1128\/CMR.00013-12","volume":"25","author":"A Morris","year":"2012","unstructured":"Morris A, Norris KA. Colonization by Pneumocystis Jirovecii and its role in disease. Clin Microbiol Rev. 2012;25:297\u2013317. https:\/\/doi.org\/10.1128\/CMR.00013-12.","journal-title":"Clin Microbiol Rev"},{"key":"9893_CR2","doi-asserted-by":"publisher","first-page":"e23","DOI":"10.1016\/j.ejim.2017.11.014","volume":"50","author":"K Alexandre","year":"2018","unstructured":"Alexandre K, Ingen-Housz-Oro S, Versini M, Sailler L, Benhamou Y. Pneumocystis Jirovecii pneumonia in patients treated with rituximab for systemic diseases: report of 11 cases and review of the literature. Eur J Intern Med. 2018;50:e23-4. https:\/\/doi.org\/10.1016\/j.ejim.2017.11.014.","journal-title":"Eur J Intern Med"},{"key":"9893_CR3","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.1080\/14787210.2022.2128762","volume":"20","author":"G Telli Dizman","year":"2022","unstructured":"Telli Dizman G, Aguado JM, Fern\u00e1ndez-Ruiz M. Risk of infection in patients with hematological malignancies receiving CAR T-cell therapy: systematic review and meta-analysis. Expert Rev Anti Infect Ther. 2022;20:1455\u201376. https:\/\/doi.org\/10.1080\/14787210.2022.2128762.","journal-title":"Expert Rev Anti Infect Ther"},{"key":"9893_CR4","doi-asserted-by":"publisher","first-page":"20878","DOI":"10.1073\/pnas.0709205105","volume":"104","author":"J-D Bouaziz","year":"2007","unstructured":"Bouaziz J-D, Yanaba K, Venturi GM, Wang Y, Tisch RM, Poe JC, et al. Therapeutic B cell depletion impairs adaptive and autoreactive CD4\u2009+\u2009T cell activation in mice. Proc Natl Acad Sci U S A. 2007;104:20878\u201383. https:\/\/doi.org\/10.1073\/pnas.0709205105.","journal-title":"Proc Natl Acad Sci U S A"},{"key":"9893_CR5","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1182\/blood.2019004000","volume":"136","author":"JA Hill","year":"2020","unstructured":"Hill JA, Seo SK. How I prevent infections in patients receiving CD19-targeted chimeric antigen receptor T cells for B-cell malignancies. Blood. 2020;136:925\u201335. https:\/\/doi.org\/10.1182\/blood.2019004000.","journal-title":"Blood"},{"key":"9893_CR6","doi-asserted-by":"publisher","first-page":"4821","DOI":"10.1182\/bloodadvances.2022007474","volume":"6","author":"JS Little","year":"2022","unstructured":"Little JS, Aleissa MM, Beluch K, Gonzalez-Bocco IH, Marty FM, Manne-Goehler J, et al. Low incidence of invasive fungal disease following CD19 chimeric antigen receptor T-cell therapy for non-hodgkin lymphoma. Blood Adv. 2022;6:4821\u201330. https:\/\/doi.org\/10.1182\/bloodadvances.2022007474.","journal-title":"Blood Adv"},{"key":"9893_CR7","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1182\/bloodadvances.2020002732","volume":"5","author":"JH Baird","year":"2021","unstructured":"Baird JH, Epstein DJ, Tamaresis JS, Ehlinger Z, Spiegel JY, Craig J, et al. Immune reconstitution and infectious complications following axicabtagene ciloleucel therapy for large B-cell lymphoma. Blood Adv. 2021;5:143\u201355. https:\/\/doi.org\/10.1182\/bloodadvances.2020002732.","journal-title":"Blood Adv"},{"key":"9893_CR8","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1055\/s-0039-3399559","volume":"41","author":"JA Fishman","year":"2020","unstructured":"Fishman JA. Pneumocystis Jiroveci. Semin Respir Crit Care Med. 2020;41:141\u201357. https:\/\/doi.org\/10.1055\/s-0039-3399559.","journal-title":"Semin Respir Crit Care Med"},{"key":"9893_CR9","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1080\/14656566.2021.1915989","volume":"22","author":"RB Weyant","year":"2021","unstructured":"Weyant RB, Kabbani D, Doucette K, Lau C, Cervera C. Pneumocystis Jirovecii: a review with a focus on prevention and treatment. Expert Opin Pharmacother. 2021;22:1579\u201392. https:\/\/doi.org\/10.1080\/14656566.2021.1915989.","journal-title":"Expert Opin Pharmacother"},{"key":"9893_CR10","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1016\/j.jiac.2014.03.003","volume":"20","author":"DP Kofteridis","year":"2014","unstructured":"Kofteridis DP, Valachis A, Velegraki M, Antoniou M, Christofaki M, Vrentzos GE, et al. Predisposing factors, clinical characteristics and outcome of Pneumonocystis Jirovecii pneumonia in HIV-negative patients. J Infect Chemother off J Jpn Soc Chemother. 2014;20:412\u20136. https:\/\/doi.org\/10.1016\/j.jiac.2014.03.003.","journal-title":"J Infect Chemother off J Jpn Soc Chemother"},{"key":"9893_CR11","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1038\/s41408-020-00346-7","volume":"10","author":"K Wudhikarn","year":"2020","unstructured":"Wudhikarn K, Palomba ML, Pennisi M, Garcia-Recio M, Flynn JR, Devlin SM, et al. Infection during the first year in patients treated with CD19 CAR T cells for diffuse large B cell lymphoma. Blood Cancer J. 2020;10:79. https:\/\/doi.org\/10.1038\/s41408-020-00346-7.","journal-title":"Blood Cancer J"},{"key":"9893_CR12","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1056\/NEJM199101243240407","volume":"324","author":"JL Jacobs","year":"1991","unstructured":"Jacobs JL, Libby DM, Winters RA, Gelmont DM, Fried ED, Hartman BJ, et al. A cluster of Pneumocystis carinii pneumonia in adults without predisposing illnesses. N Engl J Med. 1991;324:246\u201350. https:\/\/doi.org\/10.1056\/NEJM199101243240407.","journal-title":"N Engl J Med"},{"key":"9893_CR13","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1542\/peds.61.1.35","volume":"61","author":"LL Pifer","year":"1978","unstructured":"Pifer LL, Hughes WT, Stagno S, Woods D. Pneumocystis carinii infection: evidence for high prevalence in normal and immunosuppressed children. Pediatrics. 1978;61:35\u201341.","journal-title":"Pediatrics"},{"key":"9893_CR14","doi-asserted-by":"publisher","first-page":"2397","DOI":"10.1093\/jac\/dkw157","volume":"71","author":"J Maertens","year":"2016","unstructured":"Maertens J, Cesaro S, Maschmeyer G, Einsele H, Donnelly JP, Alanio A, et al. ECIL guidelines for preventing Pneumocystis Jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients. J Antimicrob Chemother. 2016;71:2397\u2013404. https:\/\/doi.org\/10.1093\/jac\/dkw157.","journal-title":"J Antimicrob Chemother"},{"key":"9893_CR15","doi-asserted-by":"publisher","DOI":"10.1002\/art.42541","author":"JW Park","year":"2023","unstructured":"Park JW, Curtis JR, Choi SR, Kim MJ, Ha Y-J, Kang EH, et al. Risk-benefit analysis of primary Prophylaxis Against Pneumocystis Jirovecii Pneumonia in patients with rheumatic diseases receiving Rituximab. Arthritis Rheumatol Hoboken NJ. 2023. https:\/\/doi.org\/10.1002\/art.42541.","journal-title":"Arthritis Rheumatol Hoboken NJ"},{"key":"9893_CR16","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s15010-020-01521-5","volume":"49","author":"I Los-Arcos","year":"2021","unstructured":"Los-Arcos I, Iacoboni G, Aguilar-Guisado M, Alsina-Manrique L, D\u00edaz de Heredia C, Fortuny-Guasch C, et al. Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy: a position paper. Infection. 2021;49:215\u201331. https:\/\/doi.org\/10.1007\/s15010-020-01521-5.","journal-title":"Infection"},{"key":"9893_CR17","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1038\/s41409-022-01756-w","volume":"57","author":"K Wudhikarn","year":"2022","unstructured":"Wudhikarn K, Perales M-A. Infectious complications, immune reconstitution, and infection prophylaxis after CD19 chimeric antigen receptor T-cell therapy. Bone Marrow Transpl. 2022;57:1477\u201388. https:\/\/doi.org\/10.1038\/s41409-022-01756-w.","journal-title":"Bone Marrow Transpl"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-024-09893-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-024-09893-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-024-09893-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,13]],"date-time":"2024-10-13T08:01:38Z","timestamp":1728806498000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-024-09893-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,13]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["9893"],"URL":"https:\/\/doi.org\/10.1186\/s12879-024-09893-x","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-4613232\/v1","asserted-by":"object"}]},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,13]]},"assertion":[{"value":"20 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 September 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 October 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the First Affiliated Hospital of Zhejiang University School of Medicine.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consents for clinical and personal details were obtained from all subjects involved in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1147"}}