Abstract
BackgroundMorbidity and mortality from Mycobacterium tuberculosis (Mtb) infection remain significant in cancer patients. We evaluated clinical characteristics, management, and outcomes in patients with active Mtb infection at our institution who had cancer or suspicion of cancer.MethodsWe retrospectively examined medical records of all patients with laboratory-confirmed active Mtb infection diagnosed between 2006 and 2014.ResultsA total of 52 patients with laboratory-confirmed active Mtb infection were identified during the study period, resulting in an average rate of 6 new cases per year. Thirty-two (62%) patients had underlying cancer, while 20 (38%) patients did not have cancer but were referred to the institution because of suspicion of underlying malignancy. Among patients with cancer, 18 (56%) had solid tumors; 8 (25%) had active hematologic malignancies; and 6 (19%) had undergone hematopoietic-cell transplantation (HCT). Patients with and without cancer were overall similar with the exception of median age (61 years in cancer patients compared to 53 years in noncancer patients). Pulmonary disease was identified in 32 (62%) patients, extrapulmonary disease in 10 (19%) patients, and disseminated disease in 10 (19%) patients. Chemotherapy was delayed in 53% of patients who were to receive such treatment. Eleven patients (all of whom had cancer) died; 3 of these deaths were attributable to Mtb infection.ConclusionsAlthough not common, tuberculosis remains an important infection in patients with cancer. Approximately one-third of patients were referred to our institution for suspicion of cancer but were ultimately diagnosed with active Mtb infection rather than malignancy.
Highlights
Morbidity and mortality from Mycobacterium tuberculosis (Mtb) infection remain significant in cancer patients
Clinical characteristics We identified 52 patients with active Mtb infection diagnosed between January 2006 and December 2014, resulting in an average of 6 new cases per year and an overall incidence rate of 0.2 cases per 1000 new cancer diagnoses compared to 1.7 cases per 1000 new hematopoietic-cell transplantation (HCT) (Fig. 1)
2 of the 3 patients with death attributable to active Mtb infection had isolates that were resistant to at least 1 first-line agent (1 to pyrazinamide and 1 to both isoniazid and streptomycin). In this retrospective study, we report the characteristics and outcomes of patients diagnosed with active Mtb infection at a comprehensive cancer center over a 9-year period of time
Summary
Morbidity and mortality from Mycobacterium tuberculosis (Mtb) infection remain significant in cancer patients. Management, and outcomes in patients with active Mtb infection at our institution who had cancer or suspicion of cancer. De La Rosa et al reported that the frequency of active Mtb infection was 0.2/1000 new cancer diagnoses and that 63% of patients with active Mtb infection had underlying hematologic malignancy [3]. Aisenberg GM et al reported the same frequency of active Mtb infection at 0.2/ 1000 new cancer diagnoses [4]. Eight (31%) out of the 26 patients with active Mtb infection in the study had been referred to our institution for evaluation of a suspicious mass thought to be malignant but were subsequently diagnosed with active Mtb infection
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
