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30 November 2014 : Original article

Hematopoietic Stem Cell Transplantation for Treatment of Patients with Leukemia Concomitant with Active Tuberculosis Infection

Mingjuan LiuAE, Caie YangBD, Lihui LiuCD, Bing ShiDF, Wenqing HuD, Liping YeCF, Yongqing ZhangAG

DOI: 10.12659/MSM.891380

Med Sci Monit 2014; 20:2484-2488

Abstract

BACKGROUND: Currently, hematopoietic stem cell transplantation is still an essential treatment approach for leukemia. However, patients with leukemia often have weakened immune function, especially more seriously compromised cellular immune response, and appear to be at greater risk for tuberculosis infection during the transplantation process. We aimed to investigate the efficacy and safety of hematopoietic stem cell transplantation for the treatment of patients with leukemia accompanying active tuberculosis infection.

MATERIAL AND METHODS: We retrospectively analyzed records of 7 consecutive patients who were diagnosed with leukemia concomitant with active tuberculosis infection and who underwent hematopoietic stem cell transplantation in our hospital from January 2006 to December 2012.

RESULTS: Among these 7 patients (4 males and 3 females; median age: 38 years; range: 30–46 years), the mean duration of anti-TB treatment before transplantation was 3 months (range: 2–4.5 months). All patients acquired engraftment, with an implantation rate of 100%. After transplantation, the mean duration of anti-TB treatment was 12 months. All patients had response after receiving anti-TB treatment. One patient died of leukemia relapse 6 months after the transplantation, but no tuberculosis infection-related death was reported.

CONCLUSIONS: Patients with leukemia concomitant with active tuberculosis infection can be treated with hematopoietic stem cell transplantation if they receive an effective anti-TB treatment regimen. The anti-TB treatment regimen had no effect against hematopoietic stem cell transplantation and was well-tolerated. All post-transplanted patients experienced no relapse of tuberculosis during the immune-suppression period. The findings in the present investigation deserve further in-depth study.

Keywords: Antitubercular Agents - therapeutic use, Adult, Hematopoietic Stem Cell Transplantation, Leukemia - therapy, Tuberculosis - drug therapy

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