title: Two children with differing outcomes after treatment for pulmonary tuberculosis diagnosed after allogeneic hematopoietic stem cell transplantation.
abstract: Tuberculosis (TB) is a rare infectious complication after hematopoietic stem cell transplantation (HSCT), but may be more significant in areas where the disease is endemic. Here, we present the clinical course of 2 children with acute lymphoblastic leukemia who were diagnosed with pulmonary TB after allogeneic HSCT. Both patients were treated for either probable or possible invasive fungal infection, as well as TB. One patient, diagnosed with TB 3 months after HSCT, showed remittent fever and symptoms that progressed to acute respiratory distress syndrome and death, despite 3 modifications to the anti-TB regimen. In contrast, another patient who was diagnosed with TB 8 months after transplantation, responded well to anti-TB medication and completed 1 year of treatment with resolution of lung lesions. Co-morbid opportunistic infections, profound host immunosuppression early after transplantation, and potential risk of multi-drug resistant-TB may act as major barriers to effective treatment of TB after HSCT despite appropriate anti-TB medication.
authors.affiliation: Division of Hematology and Oncology, Department of Pediatrics, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: J W
authors.initials: JW
authors.lastname: Lee
authors.forename: H-J
authors.initials: HJ
authors.lastname: Kwon
authors.forename: P-S
authors.initials: PS
authors.lastname: Jang
authors.forename: N-G
authors.initials: NG
authors.lastname: Chung
authors.forename: B
authors.initials: B
authors.lastname: Cho
authors.forename: D-C
authors.initials: DC
authors.lastname: Jeong
authors.forename: J-H
authors.initials: JH
authors.lastname: Kang
authors.forename: H-K
authors.initials: HK
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007165:Immunosuppression Therapy; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents