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Infections Post Transplant

Tuberculosis after hematopoietic stem cell transplantation: incidence, clinical characteristics and outcome

Bone Marrow Transplantation volume 26, pages 291–298 (2000)Cite this article

Abstract

A national survey of tuberculosis after hematopoietic stem cell transplant (SCT) was undertaken to study incidence, clinical presentation and outcome. Twenty confirmed cases were found among 8013 patients (eight in 5147 autologous and 12 in 2866 allogeneic SCT). The estimated incidence in cases/105 patients/year (95% CI) was 101 (56.5–145) for the whole group, 71.1 (21.8–120) in autologous and 135.6 (58.9–212) in allogeneic transplants. Compared with the general population, tuberculosis was more frequent after allogeneic (RR 2.95) but not after autologous SCT. Tuberculosis after SCT is a late infection (median 324 days post transplant), predominately affects the lungs (80% of the cases), appears to respond well to treatment but has a high mortality (25%) in allogeneic recipients. It can also complicate the post-transplant management as antituberculosis drugs frequently decrease the serum levels of cyclosporine causing an aggravation of GVHD. Graft-versus-host disease, corticosteroid treatment and total body irradiation appear to be associated with tuberculosis in allogeneic recipients. No obvious factors were associated with tuberculosis in autologous transplants. Finally, we found that the published literature on tuberculosis after solid and SCT has overestimated its incidence due to the direct translation of tuberculosis frequency into incidence. Bone Marrow Transplantation (2000) 26, 291–298.

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Acknowledgements

The Spanish Group on Infectious Complications in Hematopoietic Transplantation thank the following centers for their participation in this survey (city: hospital, physician).

Barcelona: Hospital Clínic, M Rovira and E Carreras; Clínica Corachán, P Vivamcos and A Grañena; Hospital de la Santa Creu i Sant Pau, R Martino; Hospital Vall d'Hebrón, T Olive, A Juliá.

Córdoba: Hospital Reina Sofia, A Torres

Granada: Hospital Universitario Virgen de las Nieves, M Jurado-Chacón.

Madrid: Hospital Clínico San Carlos, J Díaz-Mediavilla, A Casado; Hospital 12 de Octubre, JJ la Huerta; Hospital La Paz, A Martínez; Hospital Universitario de la Princesa, E Granados and R de la Cámara; Hospital Puerta de Hierro, R Cabrera; Hospital Ramón y Cajal, J López

Murcia: Hospital General Universitario, F Arriba

Palma de Mallorca: Hospital Son Dureta, J Besalduch

Pamplona: Clínica Universitaria, O Fernández-Hidalgo

Salamanca: Hospital Universitario, D Caballero

Santander: Hospital Universitario Marqués de Valdecilla, E Conde

Sevilla: Hospital Virgen del Rocío, R Parody

Valencia: Hospital Universitario La Fe, MA Sanz

Author information

Authors and Affiliations

  1. Department of Hematology, Hospital de la Princesa, Madrid, Spain

    R de la Cámara, E Granados & JM Fernández-Rañada

  2. Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    R Martino & J Sierra

  3. Department of Hematology, Hospital Clinic, Barcelona, Spain

    M Rovira & E Carreras

  4. Unit of Clinical Epidemiology, Hospital de la Princesa, Madrid, Spain

    FJ Rodriguez-Salvanés

  5. Department of Hematology, Hospital Puerta de Hierro, Madrid, Spain

    R Cabrera

  6. Department of Hematology, Hospital Ramón y Cajal, Madrid, Spain

    J López

  7. Department of Hematology, Hospital Virgen del Rocío, Sevilla, Spain

    R Parody

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  1. R de la Cámara
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de la Cámara, R., Martino, R., Granados, E. et al. Tuberculosis after hematopoietic stem cell transplantation: incidence, clinical characteristics and outcome. Bone Marrow Transplant 26, 291–298 (2000). https://doi.org/10.1038/sj.bmt.1702506

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