4.2 Article

Tuberculosis before hematopoietic stem cell transplantation in patients with hematologic diseases: report of a single-center experience

Journal

TRANSPLANT INFECTIOUS DISEASE
Volume 17, Issue 1, Pages 73-79

Publisher

WILEY-BLACKWELL
DOI: 10.1111/tid.12341

Keywords

tuberculosis; hematologic diseases; stem cell transplantation

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BackgroundFew reports discuss the optimal management of patients diagnosed with tuberculosis (TB) before scheduled stem cell transplantation (SCT), who then proceed with transplantation. MethodsWe found 13 patients with TB before SCT (proven, n=9; probable, n=3; possible, n=1) in the medical records of our institution. ResultsMost of the patients had pulmonary TB (n=8; disseminated, n=2; extrapulmonary, n=3). Eight of 9 patients with proven disease had SCT after at least 100days of anti-tuberculous medication, ranging from 103 to 450days. None of those patients suffered TB-related events after SCT. However, 1 patient with proven pulmonary TB who underwent SCT after only 40days of anti-tuberculous therapy subsequently died of TB meningitis. Patients with possible and probable disease had their transplants after 6-176days of anti-tuberculous medication, and all were alive at the time of analysis. The entire duration of anti-tuberculous medication was 12months in most cases. With a follow-up duration ranging from 0.7 to 87.5months, 4 patients died, but TB was the cause of death in only 1 case. ConclusionIn conclusion, for proven cases of TB, SCT after >100days of anti-tuberculous medication is probably feasible and safe, in terms of TB control, in patients with various hematologic diseases.

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