Mycobacterial Infections in Marrow Transplant Patients

Navari, Rudolph M.; Sullivan, Keith M.; Springmeyer, Steven C.; Siegel, Martin; Meyers, Joel D.; Buckner, C. D.; Sanders, Jean E.; Stewart, Patricia; Clift, Reginald A.; Fefer, A; Storb, R; Thomas, E. D.

doi:10.1097/00007890-198311000-00008

Cited by 69 publications

(49 citation statements)

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“…1 A high incidence of mycobacterial infections is anticipated in these patients. This report represents our experience with Mycobacterium tuberculosis following allogeneic BMT (Table 1), and concurs with the observations made by others [2][3][4][5][6][7] (Table 2). Early diagnosis of Mycobacterium tuberculosis infection in BMT recipients can be difficult, because patients are severely immunosuppressed and often neutropenic.…”

Section: Discussionsupporting

confidence: 92%

Mycobacterium tuberculosis infection in allogeneic bone marrow transplantation patients

Aljurf

Gyger

Alrajhi

et al. 1999

Bone Marrow Transplant

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Summary:Bone marrow transplant (BMT) recipients are prone to bacterial, viral and fungal infections. Mycobacterium tuberculosis infection can occur in these patients, but the incidence is lower than that of other infections. This report describes four patients with Mycobacterium tuberculosis infection identified from 641 adult patients who received a BMT over a 12-year period (prevalence 0.6%). The pre-transplant diagnosis was AML in two patients and CML in the other two. Pre-transplant conditioning consisted of BU/CY in three patients and CY/TBI in one. Graft-versus-host disease (GVHD) prophylaxis was MTX/CsA in three patients and T cell depletion of the graft in one patient. Sites of infection were lung (two), spine (one) and central nervous system (one). Onset of infection ranged from 120 days to 20 months post BMT. Two patients had co-existing CMV infection. One patient had graft failure. The two patients who received anti-tuberculous (TB) therapy recovered from the infection. Although the incidence of tuberculosis in BMT patients is not as high as in patients with solid organ transplants, late diagnosis due to the slow growth of the bacterium can lead to delay in instituting anti-TB therapy. A high index of suspicion should be maintained, particularly in endemic areas.

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Section: Discussionsupporting

confidence: 92%

Mycobacterium tuberculosis infection in allogeneic bone marrow transplantation patients

Aljurf

Gyger

Alrajhi

et al. 1999

Bone Marrow Transplant

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“…In fact, although marrow transplant recipients are prone to bacterial, viral and fungal infections, the incidence of Mycobacterium tuberculosis or Listeria monocytogenes infection is lower than other infections. [31][32][33][34] In agreement with other investigators, we have shown that the regeneration profiles of the ␣␤ T cell repertoire diversity after allogeneic blood and marrow transplantation are different…”

Section: Discussionsupporting

confidence: 92%

Reconstitution of γδ T cell repertoire diversity after human allogeneic hematopoietic cell transplantation and the role of peripheral expansion of mature T cell population in the graft

Hirokawa

Horiuchi

Kawabata

et al. 2000

Bone Marrow Transplant

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Summary:We have examined the reconstitution of ␥␦ T cell repertoire diversity after human allogeneic hematopoietic cell transplantation using a polymerase chain reaction (PCR)-based complementarity-determining region (CDR) 3 size spectratyping and DNA sequencing. The CDR3 complexity in the variable region of the T cell receptor (TCR)-␦ chain was different amongst the individuals studied. Furthermore, CDR3 size distribution patterns of allogeneic hematopoietic cell transplant recipients were almost completely recovered by a few months after transplantation. In some patients, clonal predominance of the TCRDV1+ T cells became evident during the period after transplantation. In one particular donor/recipient pair, clonal predominance of TCRDV1+ T cells was already present in blood lymphocytes of the donor, and was also observed in the recipient after transplantation. Using this donor/recipient pair, we have questioned whether ␥␦ T cell regeneration occurs via the peripheral expansion of mature T cells in the graft. In the donor lymphocytes, two expanding ␥␦ T cell clones, which were demonstrated by CDR3 sequences of the TCR-␦ chain, were recognized. These two clones were identified in the T cells from the recipient post transplant, but not before transplantation. One of the two clones was still detectable 1. years after the transplant procedure. These results strongly suggest that peripheral expansion of mature T cells in the graft is the principal pathway of ␥␦ T cell regeneration after allogeneic hematopoietic cell transplantation in adults. Bone Marrow Transplantation (2000) 26, 177-185. Keywords: T cell receptor; ␦-chain; diversity; transplantation High-dose chemoradiotherapy depletes T cells in blood and marrow transplant recipients and adequate T cell regeneration is essential for successful transplantation. The repertoire of T cells requires to be sufficiently diverse in order to recognize a wide range of microorganism-derived antigens. ␣␤ T cells are almost exclusively thymus-dependent

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“…16 Clinical features of tuberculosis following RI-UCBT might be different from those following conventional allo-HSCT. [13][14][15][16][17][18][19][20][21] Tuberculosis following conventional allo-HSCT usually occurs several months after transplantation; the median time to presentation with tuberculosis was 324 days post transplant. 18 It usually follows indolent clinical courses.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical courses of our patients were different from those in the previous reports. [13][14][15][16][17][18][19][20][21] Tuberculosis developed within 100 days of RI-UCBT, either reactivation or primary infection, and disseminated rapidly to various organs. It should be noted that all the three patients developed miliary tuberculosis, and two of the three patients were refractory to antituberculosis therapy and finally died.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 Recent studies on tuberculosis following allogeneic hematopoietic stem cell transplantation (allo-SCT) have demonstrated that this is a significant problem in endemic countries with an incidence of 0.1-5.5%. [13][14][15][16][17][18][19][20][21] This is the first report, to our knowledge, on tuberculosis following RI-UCBT. Detailed description of this complication would be informative in the management of RI-UCBT.…”

mentioning

confidence: 99%

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Disseminated tuberculosis following reduced-intensity cord blood transplantation for adult patients with hematological diseases

Maeda

Kusumi

Kami³

et al. 2004

Bone Marrow Transplant

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Mycobacterial Infections in Marrow Transplant Patients

Cited by 69 publications

References 0 publications

Mycobacterium tuberculosis infection in allogeneic bone marrow transplantation patients

Mycobacterium tuberculosis infection in allogeneic bone marrow transplantation patients

Reconstitution of γδ T cell repertoire diversity after human allogeneic hematopoietic cell transplantation and the role of peripheral expansion of mature T cell population in the graft

Disseminated tuberculosis following reduced-intensity cord blood transplantation for adult patients with hematological diseases

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