Abstract
Background: Mycobacterium tuberculosis (TB) is common worldwide, but is rarely reported after hematopoietic transplantation (HSCT). We reviewed all TB cases among HSCT since 2010 to provide an update on its epidemiology, clinical presentation, management and outcome. Methods: Several databases were reviewed from January 1, 2010 to June 30, 2018 using key words tuberculosis and hematopoietic transplantation. Results: The 47 cases of TB were reported during the study period. The highest TB frequency was reported from India (2.9%), with a median frequency of 2% (range, 0.18%-2.9%). The majority were recipients of allogeneic transplants (45/47, 95.7%). Pulmonary TB was the most common clinical presentation (20/47, 42.6%). The median time to clinical presentation was 4.6 (range, 3-12.9) and 2.4 (range, 0.6-5) months, based on cohort data and case reports, respectively. Fever was reported in 87.5% (14/16) of patients. First-line quadruple drug therapy was frequently used (29/35, 82.9%), with a median length of 12 and 9 months for cohorts and case reports, respectively. All-cause and attributable mortality was 27.6% (13/47), and 8.5% (4/47), respectively. Conclusions: Mycobacterium tuberculosis presents early after HSCT, most commonly as fever. A high index of suspicion is needed for early diagnosis and treatment, to prevent TB-attributable mortality.
| Original language | English (US) |
|---|---|
| Article number | e13430 |
| Journal | Clinical Transplantation |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
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Keywords
- bone marrow transplant
- hematopoietic stem cell transplant
- Mycobacterium tuberculosis
ASJC Scopus subject areas
- Transplantation
Cite this
An update on Mycobacterium tuberculosis infection after hematopoietic stem cell transplantation in adults. / Abad, Cybele Lara R.; Razonable, Raymund R.
In: Clinical Transplantation, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - An update on Mycobacterium tuberculosis infection after hematopoietic stem cell transplantation in adults
AU - Abad, Cybele Lara R.
AU - Razonable, Raymund R
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: Mycobacterium tuberculosis (TB) is common worldwide, but is rarely reported after hematopoietic transplantation (HSCT). We reviewed all TB cases among HSCT since 2010 to provide an update on its epidemiology, clinical presentation, management and outcome. Methods: Several databases were reviewed from January 1, 2010 to June 30, 2018 using key words tuberculosis and hematopoietic transplantation. Results: The 47 cases of TB were reported during the study period. The highest TB frequency was reported from India (2.9%), with a median frequency of 2% (range, 0.18%-2.9%). The majority were recipients of allogeneic transplants (45/47, 95.7%). Pulmonary TB was the most common clinical presentation (20/47, 42.6%). The median time to clinical presentation was 4.6 (range, 3-12.9) and 2.4 (range, 0.6-5) months, based on cohort data and case reports, respectively. Fever was reported in 87.5% (14/16) of patients. First-line quadruple drug therapy was frequently used (29/35, 82.9%), with a median length of 12 and 9 months for cohorts and case reports, respectively. All-cause and attributable mortality was 27.6% (13/47), and 8.5% (4/47), respectively. Conclusions: Mycobacterium tuberculosis presents early after HSCT, most commonly as fever. A high index of suspicion is needed for early diagnosis and treatment, to prevent TB-attributable mortality.
AB - Background: Mycobacterium tuberculosis (TB) is common worldwide, but is rarely reported after hematopoietic transplantation (HSCT). We reviewed all TB cases among HSCT since 2010 to provide an update on its epidemiology, clinical presentation, management and outcome. Methods: Several databases were reviewed from January 1, 2010 to June 30, 2018 using key words tuberculosis and hematopoietic transplantation. Results: The 47 cases of TB were reported during the study period. The highest TB frequency was reported from India (2.9%), with a median frequency of 2% (range, 0.18%-2.9%). The majority were recipients of allogeneic transplants (45/47, 95.7%). Pulmonary TB was the most common clinical presentation (20/47, 42.6%). The median time to clinical presentation was 4.6 (range, 3-12.9) and 2.4 (range, 0.6-5) months, based on cohort data and case reports, respectively. Fever was reported in 87.5% (14/16) of patients. First-line quadruple drug therapy was frequently used (29/35, 82.9%), with a median length of 12 and 9 months for cohorts and case reports, respectively. All-cause and attributable mortality was 27.6% (13/47), and 8.5% (4/47), respectively. Conclusions: Mycobacterium tuberculosis presents early after HSCT, most commonly as fever. A high index of suspicion is needed for early diagnosis and treatment, to prevent TB-attributable mortality.
KW - bone marrow transplant
KW - hematopoietic stem cell transplant
KW - Mycobacterium tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=85056267216&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85056267216&partnerID=8YFLogxK
U2 - 10.1111/ctr.13430
DO - 10.1111/ctr.13430
M3 - Article
C2 - 30347465
AN - SCOPUS:85056267216
JO - Clinical Transplantation
JF - Clinical Transplantation
SN - 0902-0063
M1 - e13430
ER -