Variation in hematological parameters during anti-tuberculosis treatment in multidrug-resistant Iraqi patients

Background and objectives. Tuberculosis affects the lungs, kidney and bone. Many anti-TB medications can affect the hematological parameters in patients. Aim. This study aimed to evaluate various hematological parameters in patients with multidrug resistance pulmonary tuberculosis (MDR) and to determine its role in different treatment courses. Patients and methods. A total of 104 patients with multidrug-resistant tuberculosis (MDR-TB) participated in our cross section study. Hematological parameters were analyzed using CBC at three different time points during a 9-month treatment course: the first 3 months (Time 0), after 6 months (Time 1), and after 9 months (Time 2). The information (by a questionnaire) were arranged into a database. All patients received Bedaqiline, Levofloxacin, Linezolid and Clofazimine. Results. Seventy eight patients (75%) had normal WBC, 23 (22.1%) had leukocytosis and 3 (2.9%) had leukopenia. Lymphocyte counts: 65 (62.5%) had normal levels, 35 (33.7%) had lymphopenia, and 4 (3.8%) had lymphocytosis. Hemoglobin levels were normal in 32 (30.8%) and 72 (69.2%) were anemic. For platelet counts, 65 (62.5%) had normal counts, 34 (32.7%) had thrombocytosis. Hematological parameters were assessed during three study periods. The mean WBC counts decreased significantly as the periods proceed. Significant difference was found in the total WBC counts between times 1 and 2. Of note, the mean counts of granulocytes progressively decreased significantly, as well as the mean platelet counts. Nevertheless, hemoglobin level significantly increased as study periods proceed. Conclusions. Anemia, leukopenia and thrombocytopenia are significant problems after MDR-TB medications. Proportion of hematological abnormalities may decrease after 3 phases of medications in MRD-TB patients.