University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey.
Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Medicine (Baltimore). 2022 Nov 18;101(46):e31786. doi: 10.1097/MD.0000000000031786.
Hematopoietic stem cell transplantation (HSCT) recipients may be at an elevated risk of developing active tuberculosis infection due to suppression in the cellular immune system. Herein, we aimed to evaluate the prevalence of latent tuberculosis and active tuberculosis in patients with allogeneic and autologous HSCT. In this cohort, data were obtained retrospectively from patients' records. The patients who were followed up in the bone marrow transplantation unit of the University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital between January 2016 and December 2019 were screened for the study. And the HSCT recipients who had tuberculin skin test and/or QuantiFERON-TB gold (QFT-GIT) test results were included in the study. A total of 361 patients were included in the study, 227 patients had autologous HSCT, and 134 patients had allogeneic HSCT. QFT-GIT was performed in 10 patients with allogeneic HSCT, and it was found positive in only 1 patient. Tuberculin skin test ≥5 mm was accepted as positive and was accepted to have latent tuberculosis, and it was positive in 18.2% (41) of the patients with autologous HSCT and was positive in 21.6% (29) of the patients with allogeneic HSCT. There was no significant difference between the 2 groups (P = .429). Isoniazid (INH) prophylaxis was started in 16.7% of patients with autologous HSCT and 22.4% of patients with allogeneic HSCT. During follow-up, active tuberculosis did not develop in any patients in both groups. There was no statistically significant difference found between allogeneic and autologous HSCT recipients regarding the prevalence of latent tuberculosis. Active tuberculosis infection did not develop in any of the patients who started INH prophylaxis. INH prophylaxis seems to be very efficient in preventing the reactivation of latent tuberculosis in patients going through allogeneic HSCT and/or autologous HSCT.
造血干细胞移植（HSCT）受者由于细胞免疫系统受到抑制，可能面临发生活动性结核感染的风险增加。在此，我们旨在评估异基因和自体 HSCT 患者中潜伏性和活动性结核的患病率。在该队列中，数据从患者的病历中回顾性获得。筛选了 2016 年 1 月至 2019 年 12 月期间在健康科学大学 Abdurrahman Yurtaslan 安卡拉肿瘤学教育与研究医院骨髓移植科接受随访的患者。并纳入了接受结核菌素皮肤试验和/或 QuantiFERON-TB gold（QFT-GIT）试验结果的 HSCT 受者。共有 361 例患者纳入研究，227 例接受自体 HSCT，134 例接受异基因 HSCT。对 10 例异基因 HSCT 患者进行了 QFT-GIT 检测，仅 1 例结果阳性。结核菌素皮肤试验≥5mm 被认为是阳性，提示存在潜伏性结核，在接受自体 HSCT 的患者中阳性率为 18.2%（41 例），在接受异基因 HSCT 的患者中阳性率为 21.6%（29 例）。两组间无显著差异（P=0.429）。16.7%的自体 HSCT 患者和 22.4%的异基因 HSCT 患者开始异烟肼（INH）预防。随访期间，两组均未发生活动性结核。异基因和自体 HSCT 受者之间潜伏性结核的患病率无统计学差异。开始 INH 预防的患者均未发生活动性结核感染。INH 预防似乎非常有效地防止异基因 HSCT 和/或自体 HSCT 患者潜伏性结核的再激活。
