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Updated: Jun 2, 2026
Intrafemoral Injection of Human Hematopoietic Stem and Progenitor Cells into Immunocompromised Mice
Published on: December 8, 2023
Two children with differing outcomes after treatment for pulmonary tuberculosis diagnosed after allogeneic
1Division of Hematology and Oncology, Department of Pediatrics, The Catholic University of Korea, Seoul, Republic of Korea.
Insights
Tuberculosis (TB) is a rare complication after hematopoietic stem cell transplantation (HSCT). Outcomes vary, with one child dying and another recovering, highlighting challenges in TB treatment post-HSCT.
Area of Science:
- Hematology
- Infectious Diseases
- Pediatric Oncology
Background:
- Tuberculosis (TB) is an uncommon but serious infection following hematopoietic stem cell transplantation (HSCT).
- The incidence of TB post-HSCT may be higher in regions where TB is endemic.
- This study examines TB in pediatric acute lymphoblastic leukemia (ALL) patients undergoing allogeneic HSCT.
Observation:
- Two pediatric patients with ALL developed pulmonary TB after allogeneic HSCT.
- Both patients received treatment for suspected invasive fungal infections concurrently with TB therapy.
- One patient experienced fatal respiratory distress despite multiple anti-TB regimen adjustments.
Findings:
- TB diagnosis 3 months post-HSCT led to fatal outcomes.
- TB diagnosis 8 months post-HSCT resulted in a favorable response to treatment and resolution of lung lesions.
- Factors influencing outcomes include co-morbid infections, profound immunosuppression, and potential multi-drug resistance.
Implications:
- Effective TB treatment post-HSCT is challenging, even with appropriate medication.
- Early diagnosis and management are critical for improving survival rates.
- Understanding risk factors like immunosuppression and drug resistance is key for optimizing patient care.
Abstract:
Tuberculosis (TB) is a rare infectious complication after hematopoietic stem cell transplantation (HSCT), but may be more significant in areas where the disease is endemic. Here, we present the clinical course of 2 children with acute lymphoblastic leukemia who were diagnosed with pulmonary TB after allogeneic HSCT. Both patients were treated for either probable or possible invasive fungal infection, as well as TB. One patient, diagnosed with TB 3 months after HSCT, showed remittent fever and symptoms that progressed to acute respiratory distress syndrome and death, despite 3 modifications to the anti-TB regimen. In contrast, another patient who was diagnosed with TB 8 months after transplantation, responded well to anti-TB medication and completed 1 year of treatment with resolution of lung lesions. Co-morbid opportunistic infections, profound host immunosuppression early after transplantation, and potential risk of multi-drug resistant-TB may act as major barriers to effective treatment of TB after HSCT despite appropriate anti-TB medication.
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