1378. Clinical Characteristics of Tuberculosis Among Patients with Cancer in an Endemic Country

Abstract

BackgroundTuberculosis (TB) is an infection caused by reactivation of Mycobacterium tuberculosis. Decreasing host immune system plays an important role in pathophysiology especially in patients with human immunodeficiency virus (HIV) infection and transplant recipients. Exposure to immunosuppressive agents among patients with solid and hematologic malignancy is likely to increase risk of TB. However, characteristics of TB in this population remain scarce.MethodsA single-center, retrospective descriptive study was conducted at King Chulalongkorn Memorial Hospital. Adult patients who developed TB between January 2008 and October 2018 after diagnosis of solid or hematologic malignancy were identified using ICD-10 code. Baseline, clinical characteristics, and treatment outcomes were collected.ResultsA total of 114 patients developed TB after diagnosis of malignancy including, 67 (58.8%) with solid tumor and 47 (41.2%) with hematologic malignancy. Lung cancer was the most common solid malignancy with TB (17.9%) followed by head and neck carcinoma (14.9%) and colorectal cancer (13.4%). For hematologic malignancies, non-Hodgkin’s lymphoma was the most common malignancy (53.2%) followed by leukemia (29.8%) and multiple myeloma (14.9%). Among patients who received immunosuppressive treatment, the mean onset of TB was 4.97 months (range 0.25 to 57 months) and 2.55 months (range 0.1 to 18 months) after treatment of solid and hematologic malignancies. Pulmonary and pleural involvement remained the most common site of infection in both groups. Mortality was highest among patients with hematologic malignancies (40.4%) while mortality in solid malignancies was 11.9%.ConclusionTB in patients with solid and hematologic malignancies contained substantial morbidity and mortality. Immunosuppressive agents and chemotherapy may play an important role especially in the endemic area. Disclosures All authors: No reported disclosures.