Multicenter retrospective analysis by the Polish Adult Leukemia Group on tuberculosis occurrence and outcomes after hematopoietic cell transplantation

Tuberculosis (TB) is an infectious complication of hematopoietic cell transplantation (HCT). There is a paucity of data on TB after HCT. Here we present the data from a low/low-intermediate TB-burden country. This was a Retrospective analysis of adult patients who developed TB after HCT. Seventeen patients were identified, 9 (52.9%) females, the median age at TB 44 years. Five (29.4%) patients underwent auto-HCT, 12 (70.6%) allo-HCT, translating into the relative frequency of TB of 0.171% for allo-HCT, and 0.063% for auto-HCT. The median time from HCT to TB was 431 days (range, 5-973). All patients had pulmonary TB. Bacteriologically confirmed TB was diagnosed in 13 (76.5%) patients; drug susceptibility testing was performed in 3/13 (23.1%). The median duration of treatment was 6 months. Twelve out of 13 evaluable patients (92.3%) obtained treatment success. With a median follow-up of 48 months (95%CI 19-95) 1-year cumulative incidence of TB-associated death was 6.7% (95%CI 0.9-40.8%). To conclude TB is a very rare infectious complication of HCT. Most frequently TB develops late after HCT. The primary site involved is the lung with no extrapulmonary TB identified in the current analysis. TB can still result in the death of the affected patient.