The demanding attention of tuberculosis in allogeneic hematopoietic stem cell transplantation recipients: High incidence compared with general population

Hyo Jin Lee; Dong Gun Lee; Su Mi Choi; Sun Hee Park; Sung Yeon Cho; Jae Ki Choi; Si Hyun Kim; Jung Hyun Choi; Jin Hong Yoo; Byung Sik Cho; Ki Seong Eom; Seok Lee; Yoo Jin Kim; Hee Je Kim; Chang Ki Min; Dong Wook Kim; Jong Wook Lee; Woo Sung Min; Jung Im Jung

doi:10.1371/journal.pone.0173250

The demanding attention of tuberculosis in allogeneic hematopoietic stem cell transplantation recipients: High incidence compared with general population

Hyo Jin Lee, Dong Gun Lee, Su Mi Choi, Sun Hee Park, Sung Yeon Cho, Jae Ki Choi, Si Hyun Kim, Jung Hyun Choi, Jin Hong Yoo, Byung Sik Cho, Ki Seong Eom, Seok Lee, Yoo Jin Kim, Hee Je Kim, Chang Ki Min, Dong Wook Kim, Jong Wook Lee, Woo Sung Min, Jung Im Jung

Research output: Contribution to journal › Article › peer-review

33 Scopus citations

Abstract

Background The risk of developing tuberculosis (TB) in allogeneic hematopoietic stem cell transplantation (HSCT) recipients is expected to be relatively high in an intermediate TB burden country. This single-center retrospective study was conducted to investigate risk factors and the incidence of TB after allogeneic HSCT. Methods From January 2004 to March 2011, 845 adult patients were enrolled. Starting April 2009, patients were given isoniazid (INH) prophylaxis based on interferon-γ release assay results. The incidence of TB was analyzed before and after April 2009, and compared it with that of the general population in Korea. Results TB was diagnosed in 21 (2.49%) of the 845 allogeneic HSCT patients. The median time to the development of TB was 386 days after transplantation (range, 49-886). Compared with the general population, the standardized incidence ratio of TB was 9.10 (95% CI; 5.59- 14.79). Extensive chronic graft-versus-host disease (GVHD) was associated with the development of TB (P = 0.003). Acute GVHD, conditioning regimen with total body irradiation and conditioning intensity were not significantly related. INH prophylaxis did not reduce the incidence of TB (P = 0.548). Among 21 TB patients, one patient had INH prophylaxis. Conclusion Allogeneic HSCT recipients especially those who suffer from extensive chronic GVHD are at a high risk of developing TB. INH prophylaxis did not statistically change the incidence of TB, however, further well-designed prospective studies are needed.

Original language	English
Article number	e0173250
Journal	PLoS ONE
Volume	12
Issue number	3
DOIs	https://doi.org/10.1371/journal.pone.0173250
State	Published - Mar 2017

Bibliographical note

Publisher Copyright:
© 2017 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1371/journal.pone.0173250

Cite this

Lee, H. J., Lee, D. G., Choi, S. M., Park, S. H., Cho, S. Y., Choi, J. K., Kim, S. H., Choi, J. H., Yoo, J. H., Cho, B. S., Eom, K. S., Lee, S., Kim, Y. J., Kim, H. J., Min, C. K., Kim, D. W., Lee, J. W., Min, W. S., & Jung, J. I. (2017). The demanding attention of tuberculosis in allogeneic hematopoietic stem cell transplantation recipients: High incidence compared with general population. PLoS ONE, 12(3), Article e0173250. https://doi.org/10.1371/journal.pone.0173250

@article{3f0b3f5e764147a1a37d3bdcc0b2d420,

title = "The demanding attention of tuberculosis in allogeneic hematopoietic stem cell transplantation recipients: High incidence compared with general population",

abstract = "Background The risk of developing tuberculosis (TB) in allogeneic hematopoietic stem cell transplantation (HSCT) recipients is expected to be relatively high in an intermediate TB burden country. This single-center retrospective study was conducted to investigate risk factors and the incidence of TB after allogeneic HSCT. Methods From January 2004 to March 2011, 845 adult patients were enrolled. Starting April 2009, patients were given isoniazid (INH) prophylaxis based on interferon-γ release assay results. The incidence of TB was analyzed before and after April 2009, and compared it with that of the general population in Korea. Results TB was diagnosed in 21 (2.49\%) of the 845 allogeneic HSCT patients. The median time to the development of TB was 386 days after transplantation (range, 49-886). Compared with the general population, the standardized incidence ratio of TB was 9.10 (95\% CI; 5.59- 14.79). Extensive chronic graft-versus-host disease (GVHD) was associated with the development of TB (P = 0.003). Acute GVHD, conditioning regimen with total body irradiation and conditioning intensity were not significantly related. INH prophylaxis did not reduce the incidence of TB (P = 0.548). Among 21 TB patients, one patient had INH prophylaxis. Conclusion Allogeneic HSCT recipients especially those who suffer from extensive chronic GVHD are at a high risk of developing TB. INH prophylaxis did not statistically change the incidence of TB, however, further well-designed prospective studies are needed.",

author = "Lee, \{Hyo Jin\} and Lee, \{Dong Gun\} and Choi, \{Su Mi\} and Park, \{Sun Hee\} and Cho, \{Sung Yeon\} and Choi, \{Jae Ki\} and Kim, \{Si Hyun\} and Choi, \{Jung Hyun\} and Yoo, \{Jin Hong\} and Cho, \{Byung Sik\} and Eom, \{Ki Seong\} and Seok Lee and Kim, \{Yoo Jin\} and Kim, \{Hee Je\} and Min, \{Chang Ki\} and Kim, \{Dong Wook\} and Lee, \{Jong Wook\} and Min, \{Woo Sung\} and Jung, \{Jung Im\}",

note = "Publisher Copyright: {\textcopyright} 2017 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2017",

month = mar,

doi = "10.1371/journal.pone.0173250",

language = "English",

volume = "12",

journal = "PLoS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "3",

}

Lee, HJ, Lee, DG, Choi, SM, Park, SH, Cho, SY, Choi, JK, Kim, SH, Choi, JH, Yoo, JH, Cho, BS, Eom, KS, Lee, S, Kim, YJ, Kim, HJ, Min, CK, Kim, DW, Lee, JW, Min, WS & Jung, JI 2017, 'The demanding attention of tuberculosis in allogeneic hematopoietic stem cell transplantation recipients: High incidence compared with general population', PLoS ONE, vol. 12, no. 3, e0173250. https://doi.org/10.1371/journal.pone.0173250

TY - JOUR

T1 - The demanding attention of tuberculosis in allogeneic hematopoietic stem cell transplantation recipients

T2 - High incidence compared with general population

AU - Lee, Hyo Jin

AU - Lee, Dong Gun

AU - Choi, Su Mi

AU - Park, Sun Hee

AU - Cho, Sung Yeon

AU - Choi, Jae Ki

AU - Kim, Si Hyun

AU - Choi, Jung Hyun

AU - Yoo, Jin Hong

AU - Cho, Byung Sik

AU - Eom, Ki Seong

AU - Lee, Seok

AU - Kim, Yoo Jin

AU - Kim, Hee Je

AU - Min, Chang Ki

AU - Kim, Dong Wook

AU - Lee, Jong Wook

AU - Min, Woo Sung

AU - Jung, Jung Im

N1 - Publisher Copyright: © 2017 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2017/3

Y1 - 2017/3

N2 - Background The risk of developing tuberculosis (TB) in allogeneic hematopoietic stem cell transplantation (HSCT) recipients is expected to be relatively high in an intermediate TB burden country. This single-center retrospective study was conducted to investigate risk factors and the incidence of TB after allogeneic HSCT. Methods From January 2004 to March 2011, 845 adult patients were enrolled. Starting April 2009, patients were given isoniazid (INH) prophylaxis based on interferon-γ release assay results. The incidence of TB was analyzed before and after April 2009, and compared it with that of the general population in Korea. Results TB was diagnosed in 21 (2.49%) of the 845 allogeneic HSCT patients. The median time to the development of TB was 386 days after transplantation (range, 49-886). Compared with the general population, the standardized incidence ratio of TB was 9.10 (95% CI; 5.59- 14.79). Extensive chronic graft-versus-host disease (GVHD) was associated with the development of TB (P = 0.003). Acute GVHD, conditioning regimen with total body irradiation and conditioning intensity were not significantly related. INH prophylaxis did not reduce the incidence of TB (P = 0.548). Among 21 TB patients, one patient had INH prophylaxis. Conclusion Allogeneic HSCT recipients especially those who suffer from extensive chronic GVHD are at a high risk of developing TB. INH prophylaxis did not statistically change the incidence of TB, however, further well-designed prospective studies are needed.

AB - Background The risk of developing tuberculosis (TB) in allogeneic hematopoietic stem cell transplantation (HSCT) recipients is expected to be relatively high in an intermediate TB burden country. This single-center retrospective study was conducted to investigate risk factors and the incidence of TB after allogeneic HSCT. Methods From January 2004 to March 2011, 845 adult patients were enrolled. Starting April 2009, patients were given isoniazid (INH) prophylaxis based on interferon-γ release assay results. The incidence of TB was analyzed before and after April 2009, and compared it with that of the general population in Korea. Results TB was diagnosed in 21 (2.49%) of the 845 allogeneic HSCT patients. The median time to the development of TB was 386 days after transplantation (range, 49-886). Compared with the general population, the standardized incidence ratio of TB was 9.10 (95% CI; 5.59- 14.79). Extensive chronic graft-versus-host disease (GVHD) was associated with the development of TB (P = 0.003). Acute GVHD, conditioning regimen with total body irradiation and conditioning intensity were not significantly related. INH prophylaxis did not reduce the incidence of TB (P = 0.548). Among 21 TB patients, one patient had INH prophylaxis. Conclusion Allogeneic HSCT recipients especially those who suffer from extensive chronic GVHD are at a high risk of developing TB. INH prophylaxis did not statistically change the incidence of TB, however, further well-designed prospective studies are needed.

UR - https://www.scopus.com/pages/publications/85014929759

U2 - 10.1371/journal.pone.0173250

DO - 10.1371/journal.pone.0173250

M3 - Article

C2 - 28278166

AN - SCOPUS:85014929759

SN - 1932-6203

VL - 12

JO - PLoS ONE

JF - PLoS ONE

IS - 3

M1 - e0173250

ER -

The demanding attention of tuberculosis in allogeneic hematopoietic stem cell transplantation recipients: High incidence compared with general population

Abstract

Bibliographical note

UN SDGs

Access to Document

Fingerprint

Cite this