Pulmonary tuberculosis in allogeneic hematopoietic stem cell transplantation

Pulmonary tuberculosis (TB) is an endemic infectious disease in Taiwan. A r etrospective study was conducted to define clinical manifestations and outc omes of patients with pulmonary TB among hematopoietic stem cell transplant ation (HSCT) recipients. We identified eight out of 350 HSCT recipients as having pulmonary TB over a 6-year period. The relative risk of having pulmo nary TB after HSCT was 13.1-fold higher than in the general population. The re was a trend toward increased risk of having pulmonary Tn in allogeneic H SCT as compared to autologous HSCT (4.8 +/-1.8% vs 0, P = 0.067). All the e ight patients with pulmonary Tn received allogeneic HSCT and most (seven of eight patients) developed the infection during treatment for GVHD. Compute d tomography of the chest was normal in one patient, with the rest showing either interstitial (two patients) or alveolar infiltrates (five patients) at the onset of pulmonary Tn, The four fatal cases had an obviously shorter duration between HSCT and onset of infection. Our data suggest that pulmon ary TB in HSCT recipients is not uncommon in this endemic area, Therefore, an effective strategy of prophylactic treatment for candidates and recipien ts of allogeneic HSCT, who may have latent pulmonary TB infection, must be developed.