PLoS ONE (Jan 2017)

The demanding attention of tuberculosis in allogeneic hematopoietic stem cell transplantation recipients: High incidence compared with general population.

  • Hyo-Jin Lee,
  • Dong-Gun Lee,
  • Su-Mi Choi,
  • Sun Hee Park,
  • Sung-Yeon Cho,
  • Jae-Ki Choi,
  • Si-Hyun Kim,
  • Jung-Hyun Choi,
  • Jin-Hong Yoo,
  • Byung-Sik Cho,
  • Ki-Seong Eom,
  • Seok Lee,
  • Yoo-Jin Kim,
  • Hee-Je Kim,
  • Chang-Ki Min,
  • Dong-Wook Kim,
  • Jong-Wook Lee,
  • Woo-Sung Min,
  • Jung Im Jung

DOI
https://doi.org/10.1371/journal.pone.0173250
Journal volume & issue
Vol. 12, no. 3
p. e0173250

Abstract

Read online

BACKGROUND:The risk of developing tuberculosis (TB) in allogeneic hematopoietic stem cell transplantation (HSCT) recipients is expected to be relatively high in an intermediate TB burden country. This single-center retrospective study was conducted to investigate risk factors and the incidence of TB after allogeneic HSCT. METHODS:From January 2004 to March 2011, 845 adult patients were enrolled. Starting April 2009, patients were given isoniazid (INH) prophylaxis based on interferon-γ release assay results. The incidence of TB was analyzed before and after April 2009, and compared it with that of the general population in Korea. RESULTS:TB was diagnosed in 21 (2.49%) of the 845 allogeneic HSCT patients. The median time to the development of TB was 386 days after transplantation (range, 49-886). Compared with the general population, the standardized incidence ratio of TB was 9.10 (95% CI; 5.59-14.79). Extensive chronic graft-versus-host disease (GVHD) was associated with the development of TB (P = 0.003). Acute GVHD, conditioning regimen with total body irradiation and conditioning intensity were not significantly related. INH prophylaxis did not reduce the incidence of TB (P = 0.548). Among 21 TB patients, one patient had INH prophylaxis. CONCLUSION:Allogeneic HSCT recipients especially those who suffer from extensive chronic GVHD are at a high risk of developing TB. INH prophylaxis did not statistically change the incidence of TB, however, further well-designed prospective studies are needed.