Parameters of Complete Blood Count and Blood Chemistry during Treatment of Patients with MDR/XDR Pulmonary Tuberculosis with a Short-Course Regimen Containing Bedaquiline, Pretomanid, and Linezolid

Abstract

The objective: assessment of changes in the parameters of complete blood count, clinical urine tests, and blood chemistry during chemotherapy of patients with MDR/XDR pulmonary tuberculosis receiving the short-course regimen containing bedaquiline, pretomanid, and linezolid (B-Pa-L).Subjects and Methods. 18 patients with MDR/pre-XDR/XDR pulmonary tuberculosis were enrolled into the study. They all received treatment at Central Tuberculosis Research Institute from 2015 to 2022.Results. In the course of chemotherapy of these patients, changes in laboratory test results were noted at different times. Abnormal changes in complete blood count were detected in 10/18 (55,6%) patients during chemotherapy for the 1st time. Hemoglobin levels, erythrocyte and leukocyte counts decreased. Hematuria and bacteriuria were detected by clinical urine test. Proteinuria was observed in almost in half of the patients. Elevated serum potassium level was frequently noted. Blood chemistry demonstrated elevated levels of ALT and AST, which is typical of cytolytic effect on hepatocytes of drugs within chemotherapy. In most cases, all above abnormalities were degree 1 of toxicity and resolved within 2-4 weeks after they were detected. Abnormalities in grade 2-3 of toxicity were mainly observed in patients receiving linezolid at the dose of 1200 mg/day. In most cases, the above abnormalities were detected during the first 4 weeks of chemotherapy.