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

Authors

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

Published in

Internal medicine (Tokyo, Japan). Sep 29, 2026. Epub Sep 29, 2026.

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.

PMID:
42816395
Bibliographic data and abstract were imported from PubMed on 01 Oct 2026.

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