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<p>Tuberculosis (TB) is rare following hematopoietic cell transplantation (HCT). In this multinational retrospective study, we report the frequency, characteristics, and outcome of TB following HCT performed during 2000–2019. Fifty-two patients (35 (67%) males, 15 (29%) children) from 24 centers developed TB following allogeneic (<i>n</i> = 47) or autologous (<i>n</i> = 5) HCT; with the relative frequency of 0.21% and 0.025%, respectively. Forty (77%) were bacteriologically, 12 (23%) clinically confirmed. The median time from HCT to TB was 135 (range, 16–3225) days. Eighteen (35%) patients with extrapulmonary TB (mainly involving lymph nodes and liver/spleen) were significantly younger, developed TB shorter after HCT, more often had inherited underlying disease, and received immunosuppressive therapy at TB diagnosis as compared to pulmonary TB. Five (22%) of 23 patients with drug-susceptibility testing performed, were resistant to at least one anti-TB drug. Treatment success was achieved in 38/50 (76%) of treated patients. One-year overall survival reached 75.7% and the 1-year cumulative incidence of TB-associated death was 18.1%. Concluding, TB is a rare, albeit severe complication, which can develop any time after HCT, frequently involves extrapulmonary sites, and results in high mortality rates. High proportion of drug-resistant TB warrants routine susceptibility testing.</p>

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Tuberculosis after hematopoietic cell transplantation: retrospective study on behalf of the Infectious Diseases Working Party of the EBMT

  • 期刊论文

  • 发表日期：

    2025年2月25日

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  • Joanna Drozd-Sokołowska,
  • Gloria Tridello,
  • Inge Verheggen,
  • Musa Karakukcu,
  • Nour Ben Abdeljelil,
  • Anca Colita,
  • Mahmoud Aljurf,
  • Nicolaus Kröger,
  • Gulyuz Ozturk,
  • Jakob Passweg,
  • Massimiliano Gambella,
  • Marina Popova,
  • Lucía López Corral,
  • Alina Tanase,
  • Agnieszka Piekarska,
  • Mohsen Al Zahrani,
  • Muhlis Cem Ar,
  • Grzegorz Basak,
  • Annoek E. C. Broers,
  • Kristina Carlson,
  • Andrew Clark,
  • Maura Faraci,
  • Pavel Jindra,
  • Gergely Kriván,
  • Sophie Ducastelle Lepretre,
  • Stephan Mielke,
  • Judith Niederland,
  • Fabrizio Pane,
  • Katharine Patrick,
  • John A. Snowden,
  • Irfan Yavasoglu,
  • Marco Zecca,
  • Anna Waszczuk-Gajda,
  • Lotus Wendel,
  • Nina Knelange,
  • Rafael de la Camara,
  • Lidia Gil,
  • Malgorzata Mikulska,
  • Dina Averbuch,
  • Jan Styczynski

摘要

Tuberculosis (TB) is rare following hematopoietic cell transplantation (HCT). In this multinational retrospective study, we report the frequency, characteristics, and outcome of TB following HCT performed during 2000–2019. Fifty-two patients (35 (67%) males, 15 (29%) children) from 24 centers developed TB following allogeneic (n = 47) or autologous (n = 5) HCT; with the relative frequency of 0.21% and 0.025%, respectively. Forty (77%) were bacteriologically, 12 (23%) clinically confirmed. The median time from HCT to TB was 135 (range, 16–3225) days. Eighteen (35%) patients with extrapulmonary TB (mainly involving lymph nodes and liver/spleen) were significantly younger, developed TB shorter after HCT, more often had inherited underlying disease, and received immunosuppressive therapy at TB diagnosis as compared to pulmonary TB. Five (22%) of 23 patients with drug-susceptibility testing performed, were resistant to at least one anti-TB drug. Treatment success was achieved in 38/50 (76%) of treated patients. One-year overall survival reached 75.7% and the 1-year cumulative incidence of TB-associated death was 18.1%. Concluding, TB is a rare, albeit severe complication, which can develop any time after HCT, frequently involves extrapulmonary sites, and results in high mortality rates. High proportion of drug-resistant TB warrants routine susceptibility testing.