Tuberculosis in hematopoietic stem cell transplant recipients

Area of Science:

• Infectious Diseases
• Hematology
• Transplantation Medicine

Background:

• Tuberculosis (TB) in Hematopoietic Stem Cell Transplant (HSCT) recipients is infrequently reported, despite its prevalence in endemic regions.
• Incidence varies significantly globally, from 0.0014% in the USA to 16% in Pakistan.

Purpose of the Study:

• To review the literature on tuberculosis occurrence in HSCT recipients.
• To highlight diagnostic timing, organ involvement, mortality, and current management uncertainties.

Main Methods:

• Literature review of TB in HSCT patients.
• Analysis of reported incidence, timing, affected organs, and outcomes.

Main Results:

• Most TB cases in HSCT patients occur more than 90 days post-transplant, with the lungs being the most commonly involved organ.
• Mortality rates range from 0% to 50%, with higher rates observed in allogeneic HSCT compared to autologous HSCT.
• Few cases are diagnosed within the first two weeks post-HSCT.

Conclusions:

• There is a lack of consensus on optimal screening methods (e.g., tuberculin skin test, QuantiFERON-TB gold) and primary prophylaxis for latent TB in HSCT recipients.
• The importance of epidemiological assessment, especially in high TB prevalence countries, needs further emphasis.