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Pneumocystis Jirovecii Pneumonia Associated with Prolonged CD4-positive T-cell Depletion after Bendamustine-Rituximab Therapy: A Case Report

Year: 2026

Type: article

Abstract: A 71-year-old man with Waldenström's macroglobulinemia developed probable Pneumocystis jirovecii pneumonia (PCP) 10 months after completing bendamustine-rituximab (BR) therapy and 7 months after discontinuing trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis. His CD4-positive T-cell count was 37 cells/μL, and no other apparent risk factors, including human immunodeficiency virus infection, were identified. While his condition improved with TMP-SMX, his CD4-positive T-cell count had only recovered to 183 cells/μL by 18 months after completing BR therapy. This case suggests that prolonged CD4-positive T-cell depletion after BR therapy may contribute to late-onset PCP and it highlights the importance of an individualized assessment of immune recovery and PCP prophylaxis.

Source: Internal Medicine

DOI: 10.2169/internalmedicine.7937-26

Authors: Haruka Zukeyama, Shuhei Ideguchi, Tomo Kiyuna, Kazutaka Yamaniha, Shosin Yamazato, Hideta Nakamura, Takeshi Kinjo, Makoto Furugen, Kazuya Miyagi, Kazuko Yamamoto

Institution: University of the Ryukyus

Language: English

Topic: Pneumocystis jirovecii pneumonia detection and treatment

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7214631771

FWCI: 3.764

Cites:

Cited by: 1

Related to: 10