Clinical characteristics and treatment outcomes of active tuberculosis complicated after hematopoietic stem cell transplantation
HU Nai-bo
HU Xin-yang
LIU Yang
JI Wen-ting
NIU Zhi-yuan
LI Ya-nan
LI Yan-song
WANG Hua-quan
GAO Jing-tao
Abstract：Objective To investigate the clinical characteristics and treatment outcomes of active tuberculosis(ATB)complicating hematopoietic stem cell transplantation(HSCT),and to provide evidence for early detection and improved treatment outcomes of tuberculosis after HSCT.Methods Data from patients who developed ATB after HSCT were collected from the department of hematology at Tianjin University Haihe Hospital from September 2024 to May 2025.The onset time,clinical manifestations,laboratory tests,imaging features,antituberculosis treatment outcomes,and adverse events were analyzed.Results A total of 7 HSCT patients developed ATB,with a median onset time of 4.0(1.3,4.6)months after transplantation.Secondary pulmonary tuberculosis was the most common form,and fever was the initial symptom.Imaging findings predominantly showed consolidation and ground-glass opacity.The diagnostic yield of sputum smear and culture was low.The antituberculosis treatment mainly included isoniazid and fluoroquinolones,with rifapentine used as a substitute for rifampicin.The median treatment duration during the study period was 3.3(2.1,5.2)months,and 42.9％(3/7)of patients showed effective antituberculosis treatment at the end of 2 months.Liver function impairment was a common adverse event.The primary hematological diseases in HSCT patients were diverse,with 85.7％(6/7)undergoing allogeneic HSCT.Conclusion Early identification and prompt treatment of ATB after HSCT are crucial due to its insidious onset and low detection rate by routine examinations,which can easily lead to misdiagnosis and missed diagnosis.The recommended treatment regimen for tuberculosis after HSCT is similar to the standard four-drug regimen used in the general population.However,the potential for antituberculosis drugs to cause bone marrow suppression and interact with immunosuppressive agents should be considered to optimize medication use,reduce adverse events,and improve treatment outcomes.
Keywords：hematopoietic stem cell transplantationactive tuberculosisclinical characteristicstreatment outcomes
Publication Date：2025-10-01
Online Publishing Date：2025-12-04(First online date of this platform, not the publication date of the document)
Pages：6( 875-880 )