An HIV-negative patient who is immunocompromised may require prophylactic therapy against Pneumocystis carinii (PCP) under certain circumstances.
Autologous bone marrow transplant:
(1) after intensive conditioning
(2) after graft manipulation
(3) after therapy with fludarabine or 2-CDA (2-chlorodeoxyadenosine)
Solid organ transplant recipient (heart, lung, liver, kidney, etc.):
(1) frequent PCP infections at institution
(2) history of PCP infection
(3) history of frequent opportunistic infection
(4) history of CMV infection or high risk for CMV infection
(5) intensive immune suppression for acute allograft rejection
(6) intensive immune suppression for graft vs host disease
(7) anti-T-cell therapy
Hematopoietic stem cell transplantation:
(1) frequent PCP infections at institution
(2) history of PCP infection
(3) history of frequent opportunistic infection
(4) history of CMV infection or high risk for CMV infection
(5) intensive immune suppression for acute allograft rejection
(6) intensive immune suppression for graft vs host disease
(7) anti-T-cell therapy
Bone marrow transplantation:
(1) frequent PCP infections at institution
(2) history of PCP infection
(3) history of frequent opportunistic infection
(4) history of CMV infection or high risk for CMV infection
(5) intensive immune suppression for acute allograft rejection
(6) intensive immune suppression for graft vs host disease
(7) anti-T-cell therapy
Corticosteroid therapy:
(1) >= 20 mg per day prednisone >= 3 weeks
Prolonged neutropenia, provided any bone marrow suppression associated with prophylactic therapy can be tolerated
Chemotherapy for ALL, chronic lymphocytic leukemia (CLL) or non-Hodgkin's lymphoma (may involve corticosteroids and/or prolonged neutropenia)
Specialty: Infectious Diseases, Pharmacology, clinical