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Pulmonary Tuberculosis IV01:26

Pulmonary Tuberculosis IV

Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
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Causative Organism
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Growth Differentiation Factor-15 Could Predict Decreased Hemoglobin in Tuberculosis Treated With Linezolid-Containing

Amaylia Oehadian1, Prayudi Santoso2, Delita Prihatni3

  • 1Hematology and Medical Oncology Division, Department of Internal Medicine, Dr. Hasan Sadikin General Hospital/Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.

The Clinical Respiratory Journal
|May 8, 2026
PubMed
Summary

Baseline Growth Differentiation Factor-15 (GDF-15) levels can predict myelosuppression in patients with rifampicin-resistant tuberculosis (RR-TB) treated with linezolid. Higher GDF-15 levels indicate a greater risk of hemoglobin reduction during treatment.

Keywords:
GDF‐15RR‐TBhemoglobinlinezolid

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Area of Science:

  • Pharmacology
  • Hematology
  • Infectious Diseases

Background:

  • Linezolid is crucial for treating rifampicin-resistant tuberculosis (RR-TB).
  • Linezolid treatment can lead to significant hematological toxicities, including myelosuppression, due to mitochondrial dysfunction in hematopoietic stem cells.
  • Growth Differentiation Factor-15 (GDF-15) is a potential biomarker for this mitochondrial dysfunction.

Purpose of the Study:

  • To investigate if baseline GDF-15 levels can predict myelosuppression in RR-TB patients receiving linezolid.
  • To establish a correlation between GDF-15 levels and hematological changes during linezolid therapy.

Main Methods:

  • A cohort of 97 RR-TB patients treated with linezolid-containing regimens for at least 4 weeks was studied.
  • Hematological parameters and GDF-15 levels were measured at baseline, week 2, and weeks 4-8 of treatment.
  • Statistical analyses, including correlation and AUC calculations, were performed to assess the predictive value of GDF-15.

Main Results:

  • GDF-15 levels significantly increased by week 2 of linezolid treatment (p=0.003).
  • Myelosuppression, specifically hemoglobin reduction, occurred in 65% of patients by weeks 4-8.
  • Baseline GDF-15 levels correlated with hemoglobin reduction (r=0.4, p<0.001) and levels >950 pg/mL predicted >25% hemoglobin reduction (AUC 0.756).

Conclusions:

  • Baseline GDF-15 levels are a significant predictor of myelosuppression, particularly hemoglobin changes, in RR-TB patients on linezolid.
  • GDF-15 serves as a valuable biomarker for monitoring and managing linezolid-induced hematological toxicity in this population.