Pneumocystis Jirovecii Pneumonia Associated with Prolonged CD4-positive T-cell Depletion after Bendamustine-Rituximab Therapy: A Case Report
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.
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BibTeX
@article{zukeyama2026pneumocystis,
title = {{Pneumocystis Jirovecii Pneumonia Associated with Prolonged CD4-positive T-cell Depletion after Bendamustine-Rituximab Therapy: A Case Report}},
author = {Haruka Zukeyama and Shuhei Ideguchi and Tomo Kiyuna and Kazutaka Yamaniha and Shosin Yamazato and Hideta Nakamura and Takeshi Kinjo and Makoto Furugen and Kazuya Miyagi and Kazuko Yamamoto},
journal = {Internal Medicine},
year = {2026},
month = sep,
doi = {10.2169/internalmedicine.7937-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7937-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Pneumocystis Jirovecii Pneumonia Associated with Prolonged CD4-positive T-cell Depletion after Bendamustine-Rituximab Therapy: A Case Report
AU - Haruka Zukeyama
AU - Shuhei Ideguchi
AU - Tomo Kiyuna
AU - Kazutaka Yamaniha
AU - Shosin Yamazato
AU - Hideta Nakamura
AU - Takeshi Kinjo
AU - Makoto Furugen
AU - Kazuya Miyagi
AU - Kazuko Yamamoto
PY - 2026
DA - 2026/09/29
JO - Internal Medicine
DO - 10.2169/internalmedicine.7937-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7937-26/_article
AB - 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.
SN - 1349-7235
SN - 0918-2918
ER -