The frequency of tuberculosis in adult allogeneic stem cell transplant recipients in Turkey

Abstract

In general, tuberculosis (Tb) is rarely seen in allogeneic stem cell transplant (alloSCT) recipients, but this observation has been challenged in developing countries such as Turkey, where Tb infection is more prevalent than in Europe and the US. In this retrospective study, we report on the incidence of Tb infections in 351 alloSCT recipients at 4 bone marrow transplantation units in Turkey over the last 10 years. The frequency of Tb in alloSCT recipients after allografting (5 of 351) was far greater than that in the general population (35.4 per 100,000). Of the 351 patients who underwent alloSCT, 77 who received isoniazid (INH) chemoprophylaxis for 6 months did not develop posttransplantation Tb. However, 5 of the remaining 274 patients who received no chemoprophylaxis developed Tb a median of 12 months (range, 10-47 months) after allografting. Antituberculosis therapy resulted in complete recovery in all cases. In 2 additional patients who were found to have active pulmonary Tb at the time of transplantation, alloSCT was delayed until the infections were treated. Infections of mycobacteria other than Mycobacterium tuberculosis were not observed. The number of patients who received and tolerated INH may not be sufficient for firm conclusions, but the data suggest that, in countries where Tb is prevalent, pre- and posttransplantation follow-up for Tb and the use of INH prophylaxis should be considered.

Infectious complications and outcomes after allogeneic hematopoietic stem cell transplantation in Korea

“…[40][41][42] However, in endemic countries, high incidence up to 5% has been reported. 43,44 Although prevalence of tuberculosis has dramatically decreased nowadays, Korea is still a tuberculosis-endemic country. According to the seventh nationwide tuberculosis survey in Korea, 1995, prevalence of active tuberculosis is 1032/100 000.…”

High rates of infection and colonization by nontuberculous mycobacteria after allogeneic hematopoietic stem cell transplantation

“…21,24 Despite their pathogenicity among a wide variety of hosts, NTM are uncommon pathogens in alloSCT recipients according to published reports. 8,9,12,15,25 Table 2 includes a comparison of the patients reported here and those from other series. The rates of positive cultures for NTM and NTM infection were 5-to 20-fold higher at our institution than at other centers.…”

“…Both Mycobacterium tuberculosis and nontuberculous mycobacteria (NTM) are well-described pathogens in alloSCT recipients. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] However, distinguishing infection from colonization by NTM such as Mycobacterium avium complex (MAC) can be difficult, as infection by organisms other than NTM and noninfectious conditions such as graft-versus-host disease (GvHD) can mimic NTM infection in alloSCT recipients. Formal diagnostic criteria for NTM infection ( Figure 1) have been established by the Centers for Disease Control and Prevention (CDC) and the American Thoracic Society but remain controversial.…”

Infections among allogeneic bone marrow transplant recipients in India

“…21 Studies from developing countries, including Turkey and Hong Kong, have reported incidences varying between 1 and 12%. [22][23][24] In view of the low incidence in India, INAH prophylaxis during BMT may not be essential.…”