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

In general, tuberculosis (Tb) is rarely seen in allogeneic stem cell transp lant (alloSCT) recipients, but this observation has been challenged in deve loping countries such as Turkey, where Tb infection is more prevalent than in Europe and the US. In this retrospective study, we report on the inciden ce of Tb infections in 351 alloSCT recipients at 4 bone marrow transplantat ion 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 g eneral population (35.4 per 100,000). Of the 351 patients who underwent all oSCT, 77 who received isoniazid (INH) chemoprophylaxis for 6 months did not develop posttransplantation Tb. However, 5 of the remaining 274 patients w ho received no chemoprophylaxis developed Tb a median of 12 months (range, 10-47 months) after allografting. Antituberculosis therapy resulted in comp lete recovery in all cases. In 2 additional patients who were found to have active pulmonary Tb at the time of transplantation, alloSCT was delayed un til the infections were treated. Infections of mycobacteria other than Myco bacterium tuberculosis were not observed. The number of patients who receiv ed and tolerated INH may not be sufficient for firm conclusions, but the da ta suggest that, in countries where Tb is prevalent, pre- and posttransplan tation follow-up for Tb and the use of INH prophylaxis should be considered .