A Role for Isoniazid Prophylaxis Against Mycobacterium Tuberculosis During Treatment for Acute Myeloid Leukaemia in Highly Endemic Areas?

Hematological malignancy is an increasing burden on the Tanzanian healthcare system accounting for around 10% of all cancer diagnosis [1]. Acute myeloid leukemia (AML) is particularly challenging in the context of limited diagnostic services, restricted blood product availability, high cost of chemotherapy drugs and the complete absence of bone marrow transplantation. Despite this Kilimanjaro Christian Medical Centre (KCMC) has attempted to overcome these barriers and has commenced induction therapy with daunorubicin and cytarabine in a number of suitable candidates in an attempt to treat their disease. However, to date treatment during nadir poses an unresolved threat despite the use of prophylactic antiviral, anti-fungal and antibiotic therapies and broad-spectrum antibiotics in the case of infection.