Implementation of a Routine Screening Program for Latent Tuberculosis Infection among Patients with Acute Leukemia at a Canadian Cancer Center
BACKGROUND: Screening for latent tuberculosis infection (LTBI) in patients with hematological malignancy is recommended because of their increased risk of tuberculosis (TB). We assessed the utility of tuberculin skin test (TST) screening in patients with acute leukemia and subsequent outcomes of LTBI treatment.
METHODS: We retrospectively evaluated patients ≥16 years of age with acute leukemia from 2013-2014 with a TST planted and read prior to the initiation of antineoplastic chemotherapy treatment. Demographics, clinical information and treatment outcomes of LTBI therapy were compared between patients with positive TST (≥10 mm induration) and negative TST.
RESULTS: A total of 389 patients with acute leukemia were included in the cohort. Of them, 37/389 (9.5%) had a positive TST. Only 3.4% (8/235) of individuals originating from North and South America as well as the Caribbean were TST positive, while 21% (20/95) of individuals from Asia were TST positive. Diagnostic imaging findings consistent with prior tuberculosis infection were higher in TST positive patients compared to TST negative ones (29.7% versus 9.4%, p < 0.0001). Furthermore, 31/38 patients (81.6%) who were TST positive received LTBI therapy, which was well tolerated. There was no significant difference in overall survival among those who received LTBI therapy compared to those who did not. No patients developed active TB.
CONCLUSIONS: Universal screening with TST may be of low yield in individuals with acute leukemia unless patients originate from a TB endemic country. When therapy for LTBI is prescribed, patients with acute leukemia do not experience drug-induced liver toxicity and are likely to complete the intended duration of therapy, thus preventing the development of active tuberculosis.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
|---|---|
| Enthalten in: |
Current oncology (Toronto, Ont.) - 29(2022), 12 vom: 29. Nov., Seite 9325-9334 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Taha, Rbab [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Journal Article |
|---|
| Anmerkungen: |
Date Completed 26.12.2022 Date Revised 12.01.2023 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.3390/curroncol29120731 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM350586896 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM350586896 | ||
| 003 | DE-627 | ||
| 005 | 20231226045329.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3390/curroncol29120731 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1168.xml |
| 035 | |a (DE-627)NLM350586896 | ||
| 035 | |a (NLM)36547145 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Taha, Rbab |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Implementation of a Routine Screening Program for Latent Tuberculosis Infection among Patients with Acute Leukemia at a Canadian Cancer Center |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 26.12.2022 | ||
| 500 | |a Date Revised 12.01.2023 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Screening for latent tuberculosis infection (LTBI) in patients with hematological malignancy is recommended because of their increased risk of tuberculosis (TB). We assessed the utility of tuberculin skin test (TST) screening in patients with acute leukemia and subsequent outcomes of LTBI treatment | ||
| 520 | |a METHODS: We retrospectively evaluated patients ≥16 years of age with acute leukemia from 2013-2014 with a TST planted and read prior to the initiation of antineoplastic chemotherapy treatment. Demographics, clinical information and treatment outcomes of LTBI therapy were compared between patients with positive TST (≥10 mm induration) and negative TST | ||
| 520 | |a RESULTS: A total of 389 patients with acute leukemia were included in the cohort. Of them, 37/389 (9.5%) had a positive TST. Only 3.4% (8/235) of individuals originating from North and South America as well as the Caribbean were TST positive, while 21% (20/95) of individuals from Asia were TST positive. Diagnostic imaging findings consistent with prior tuberculosis infection were higher in TST positive patients compared to TST negative ones (29.7% versus 9.4%, p < 0.0001). Furthermore, 31/38 patients (81.6%) who were TST positive received LTBI therapy, which was well tolerated. There was no significant difference in overall survival among those who received LTBI therapy compared to those who did not. No patients developed active TB | ||
| 520 | |a CONCLUSIONS: Universal screening with TST may be of low yield in individuals with acute leukemia unless patients originate from a TB endemic country. When therapy for LTBI is prescribed, patients with acute leukemia do not experience drug-induced liver toxicity and are likely to complete the intended duration of therapy, thus preventing the development of active tuberculosis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a latent tuberculosis infection | |
| 650 | 4 | |a leukemia | |
| 650 | 4 | |a tuberculin skin testing | |
| 700 | 1 | |a Kothari, Sagar |e verfasserin |4 aut | |
| 700 | 1 | |a Foroutan, Farid |e verfasserin |4 aut | |
| 700 | 1 | |a Gitman, Melissa |e verfasserin |4 aut | |
| 700 | 1 | |a Gupta, Vikas |e verfasserin |4 aut | |
| 700 | 1 | |a Nguyen, Tram |e verfasserin |4 aut | |
| 700 | 1 | |a Rotstein, Coleman |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Current oncology (Toronto, Ont.) |d 1998 |g 29(2022), 12 vom: 29. Nov., Seite 9325-9334 |w (DE-627)NLM09444482X |x 1718-7729 |7 nnns |
| 773 | 1 | 8 | |g volume:29 |g year:2022 |g number:12 |g day:29 |g month:11 |g pages:9325-9334 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.3390/curroncol29120731 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 29 |j 2022 |e 12 |b 29 |c 11 |h 9325-9334 | ||