Tuberculosis in acute leukemia: A clinico-hematological profile

Mishra, Pravas; Kumar, Rajat; Mahapatra, Manoranjan; Sharma, Sanjay; Dixit, Ashish; Chaterjee, Tathagat; Choudhry, Dharma R.; Saxena, Renu; Choudhry, V. P.

doi:10.1080/10245330600915818

Cited by 32 publications

(26 citation statements)

References 19 publications

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“…All patients responded successfully to standard 4 drugs ATT (mentioned above). Similar observations have been made by others also [41]. Thus, a diagnosis of tuberculosis should be considered in cases of non-resolving fever presenting with pneumonia with necrotic mediastinal lymphadenopathy especially in areas with high incidence of the disease.…”

Section: Discussionsupporting

confidence: 63%

Infections in acute myeloid leukemia: an analysis of 382 febrile episodes

Gupta

Singh

et al. 2009

Med Oncol

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Neutropenic fever is an important cause of morbidity and mortality during therapy of acute myeloid leukemia (AML). We retrospectively analyzed 382 febrile episodes encountered during induction and consolidation chemotherapy to determine the potential etiology, microbiologic spectrum, response/resistance to antibiotics and outcome. Between May, 2001 and December, 2006, 95 patients with de novo non-M3 AML received remission induction chemotherapy followed by consolidation in those who achieved complete remission. Patients median age was 28 years, ranging from 2 to 61 years, 26 patients were ≤15 years of age. There were 57 males and 38 females. Febrile neutropenia was defined as per international guidelines. A total of 382 febrile episodes were recorded; neutropenic 347 (induction phase 172, consolidation phase 175) and non-neutropenic 35 (induction 16, consolidation 19). Clinical, microbiological and radiological evidence of infection could be identified in 64% of the febrile episodes (74% during induction, 52% during consolidation). Pulmonary infections were most common, both during induction and consolidation phase. Microbiologically gram-negative infections predominated. There were 60 possible/probable/definite episodes of fungal infection. Six cases of tuberculosis (pulmonary 5 and spine 1) and 3 cases of malaria (including one case of cerebral malaria) were also identified. Nineteen patients died (17 during induction, 2 during consolidation); 17 deaths were infection related, 12/17 possibly due to fungal infections. We suggest that evaluation of antibacterial resistance patterns in an institution must be done routinely in order to choose empiric antibiotics therapy. Careful selection of antibiotics and early institution of antifungal therapy besides considering alternative diagnosis peculiar to the region (e.g. tuberculosis, malaria) may help in reducing morbidity and mortality during AML therapy.

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Section: Discussionsupporting

confidence: 63%

Infections in acute myeloid leukemia: an analysis of 382 febrile episodes

Gupta

Singh

et al. 2009

Med Oncol

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“…It predominantly affects males with chronic myeloproliferative disorders, myelodysplasia, and AML [1]. Chen et al and Mishra et al reported that patients with AML rather than other types of hematologic malignancies had a higher rate of tuberculous infections due to Mycobacterium tuberculosis [2, 3]. It can precede or occur simultaneously or during treatment of hematological malignancies [4]; usually the prevalence in those patients ranges between 2.1 and 2.6% and when present it is usually disseminated [5].…”

Section: Discussionmentioning

confidence: 99%

Acute Myeloid Leukemia Presenting with Pulmonary Tuberculosis

Thomas

Al-Gherbawe

2014

Case Reports in Infectious Diseases

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We report the case of a 58-year-old immunocompetent man presenting with fever, cough, anorexia, weight loss, and cervical lymphadenopathy. Blood investigations revealed severe neutropenia with monocytosis. Chest imaging showed bilateral reticular infiltrates with mediastinal widening. Bronchoalveolar lavage culture and molecular test were positive for Mycobacterium tuberculosis and treatment with isoniazid, rifampicin, pyrazinamide, and ethambutol was started. Although pulmonary tuberculosis could explain this clinical presentation we suspected associated blood dyscrasias in view of significant monocytosis and mild splenomegaly. Bone marrow aspiration revealed acute myeloid leukemia. Thereafter the patient received induction chemotherapy and continued antituberculous treatment. After first induction of chemotherapy patient was in remission and successfully completed 6 months antituberculosis therapy without any complications. To our knowledge there has been no such case reported from the State of Qatar to date.

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“…The estimated prevalence of TB in AL varies between 3 -4/1000 new cases, in western countries [12] that patients with AML rather than lymphoma had a higher rate of MT disease [14]. Chen et al [26] found that patients with AML in Thailand had significantly high incidence of TB than other sub-types of HM (2.87% versus 1.21%).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Delay and Associated Clinical Features of Tuberculosis among Adult Patients with Acute Myeloid Leukemia in Doha, Qatar

Omri¹,

Taha²,

Ibrahim³

et al. 2018

JTR

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Background: Tuberculosis is currently the world's leading cause of death arising from a single infectious condition. While T cell mediated immunity is recognized to have a major contribution to tuberculosis activation, the present investigation confirmed that TB was more prevalent among patients with acute myeloid rather than lymphoid leukemia and such association was frequently overlooked. The primary objective of this study is to estimate the diagnostic delay of tuberculosis among patients with acute myeloid leukemia (AML) and compare it to the general population in Qatar. Secondary objective is to study the clinical and epidemiologic characteristics of tuberculosis in patients with AML. Methods: This is a retrospective study of tuberculosis cases diagnosed in subjects with AML during the period from January 2008 till December 2016. Results: Among 215 subjects with AML identified during the study period, 12 (5.58%) received the diagnosis of tuberculosis. The estimated incidence of tuberculosis among AML cases was 7.14 cases per 1000 per year. The mean delay in diagnosis of tuberculosis was 64.2 days (95% CI: 26.8 -101.5) and the median was 45 days (interquartile range; Q1 -Q3, 29.5 -97.5). Prolonged fever was the most common presentation (100% of cases). Parenchymal lung involvement was the most common radiologic abnormality (83.3% of cases). Three patients (25%) died and 8 patients completed 9 to 12 months of anti-tuberculous treatment with clinical and radiological remission. Conclusion: Infections caused by Mycobacterium tuberculosis are not How to cite this paper: El Omri, H., Taha, R., Ibrahim, W., Kassem, N., Szabados, L., El Sabah, H., Abid, F.B., Gamiel, A., Al Khinji, A., Szmeigielski, W., Hasan, S. and Al Hijji, I. (2018

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Tuberculosis in acute leukemia: A clinico-hematological profile

Cited by 32 publications

References 19 publications

Infections in acute myeloid leukemia: an analysis of 382 febrile episodes

Infections in acute myeloid leukemia: an analysis of 382 febrile episodes

Acute Myeloid Leukemia Presenting with Pulmonary Tuberculosis

Diagnostic Delay and Associated Clinical Features of Tuberculosis among Adult Patients with Acute Myeloid Leukemia in Doha, Qatar

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