Abstract
Children who undergo bone marrow transplantation (BMT) are at risk for Pneumocystis carinii pneu- monia (PCP). Prophylaxis using trimethoprim/sulfa- methoxazole (TMP/SMX) is highly effective but the incidence of adverse drug reactions is significant. We retrospectively reviewed 33 pediatric BMT (25 allogeneic and eight autologous) in whom dapsone was used for PCP prophylaxis because patients were unable to receive TMP/SMX. Dapsone was administered at 50 mg/m2 p.o. once a week from engraftment to 180 days post-autologous BMT, and to 1 year or throughout the duration of immunosuppressive treatment post-allogeneic BMT. With a total of 7268 patient days of dapsone prophylaxis and a median follow-up of 353 days post-BMT, no proven PCP was diagnosed. Sixteen cases of chest radiograph abnormalities were noted in this patient population but none was attributed to PCP. Dapsone was well tolerated by all children with no serious adverse effects; however, one patient developed Toxoplasma gondii encephalitis during dapsone prophylaxis. Dapsone warrants further evaluation as an alternative for PCP prophylaxis in pediatric BMT patients intolerant of TMP/SMX. Additional prophylaxis should be considered for patients at high risk for T. gondii encephalitis.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Maltezou, H., Petropoulos, D., Choroszy, M. et al. Dapsone for Pneumocystis carinii prophylaxis in children undergoing bone marrow transplantation. Bone Marrow Transplant 20, 879–881 (1997). https://doi.org/10.1038/sj.bmt.1700978
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1700978
Keywords
This article is cited by
-
The incidence, mortality and timing of Pneumocystis jiroveci pneumonia after hematopoietic cell transplantation: a CIBMTR analysis
Bone Marrow Transplantation (2016)
-
Pneumocystis Pneumonia: Epidemiology and Options for Prophylaxis in Non-HIV Immunocompromised Pediatric Patients
Current Fungal Infection Reports (2014)
-
Medikamentöse Prophylaxe während intensivierter Immunsuppression bei Kindern und Jugendlichen
Zeitschrift für Rheumatologie (2013)
-
References
Bone Marrow Transplantation (2009)
-
Prevention of infectious complications in pediatric HSCT
Bone Marrow Transplantation (2008)