ACUTE LEUKEMIA AND LATENT TUBERCULOSIS INFECTION IN ITALY: QUANTIFERON-TB TEST SCREENING IN A LOW TUBERCULOSIS INCIDENCE COUNTRY
Background and objectives Identification of latent tuberculosis infection (LTBI) is a critical step of tuberculosis surveillance, especially in low incidence countries, and is limited to situations with a higher probability of developing active disease, e.g., patients with hematological malignan...
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PAGEPress Publications
2024-06-01
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| Series: | Mediterranean Journal of Hematology and Infectious Diseases |
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| Online Access: | https://www.mjhid.org/mjhid/article/view/5662 |
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| author | Andrea Nunzi Luigi Della Valle Elisa Linnea Lindfors Rossi Giorgia Ranucci Flavia Mallegni Federico Moretti Elisa Meddi Luca Guarnera Ilaria Tiravanti Kristian Taka Elisa Buzzatti Fabiana Esposito Roberto Secchi Francesca Di Giuliano Flavia Chirico Raffaele Palmieri Luca Maurillo Francesco Buccisano Carmelo Gurnari Giovangiacinto Paterno Adriano Venditti Maria Ilaria Del Principe |
| author_facet | Andrea Nunzi Luigi Della Valle Elisa Linnea Lindfors Rossi Giorgia Ranucci Flavia Mallegni Federico Moretti Elisa Meddi Luca Guarnera Ilaria Tiravanti Kristian Taka Elisa Buzzatti Fabiana Esposito Roberto Secchi Francesca Di Giuliano Flavia Chirico Raffaele Palmieri Luca Maurillo Francesco Buccisano Carmelo Gurnari Giovangiacinto Paterno Adriano Venditti Maria Ilaria Del Principe |
| author_sort | Andrea Nunzi |
| collection | DOAJ |
| description |
Background and objectives
Identification of latent tuberculosis infection (LTBI) is a critical step of tuberculosis surveillance, especially in low incidence countries, and is limited to situations with a higher probability of developing active disease, e.g., patients with hematological malignancies. According to guidelines, in TB non-endemic countries no clear screening program is established at diagnosis for patients with acute leukemia (AL).
The primary endpoint of this study was to establish the LTBI incidence in patients with diagnosis of AL using QuantiFERON (QFT)-TB. Secondarily, TB-specific prophylaxis efficacy and safety, and features driving increased risk of LTBI were evaluated.
Methods
QFT-TB screening was performed before induction, consolidation or during follow-up, in all patients with AL (myeloid and lymphoid), treated at our Institution between October 2019 and August 2023.
Results
We accrued 62 patients, of whom 7 (11,3%) tested positive, without any symptoms or signs of active TB, and 2 (3,2%) resulted as indeterminate. All positive patients started prophylaxis with isoniazid 300 mg/die, while patients whose test was indeterminate did not receive any prophylaxis. Active TB was excluded by imaging, as well as microscopic, cultural, and molecular examination on bronchoalveolar lavage. During the 46-month period of observation, none of the patients developed TB reactivation.
Conclusions
In our country, LTBI is not uncommon as expected. Despite the low sample size, 1 out of 10 of our patients had prior TB exposure. This finding suggests implementing TB screening in the pre-treatment setting, particularly in a time when more numerous active treatments are becoming available also for patients ineligible to intensive chemotherapy.
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| format | Article |
| id | doaj-art-d1b583dbf5f142fa901c505b08718bd5 |
| institution | Kabale University |
| issn | 2035-3006 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Mediterranean Journal of Hematology and Infectious Diseases |
| spelling | doaj-art-d1b583dbf5f142fa901c505b08718bd52025-01-03T00:28:00ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062024-06-0116110.4084/MJHID.2024.054ACUTE LEUKEMIA AND LATENT TUBERCULOSIS INFECTION IN ITALY: QUANTIFERON-TB TEST SCREENING IN A LOW TUBERCULOSIS INCIDENCE COUNTRYAndrea Nunzi0Luigi Della Valle1Elisa Linnea Lindfors Rossi2Giorgia Ranucci3Flavia Mallegni4Federico Moretti5Elisa Meddi6Luca Guarnera7Ilaria Tiravanti8Kristian Taka9Elisa Buzzatti10Fabiana Esposito11Roberto Secchi12Francesca Di Giuliano13Flavia Chirico14Raffaele Palmieri15Luca Maurillo16Francesco Buccisano17Carmelo Gurnari18Giovangiacinto Paterno19Adriano Venditti20Maria Ilaria Del Principe21a:1:{s:5:"en_US";s:43:"Università degli Studi di Roma Tor Vergata";}1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.2. Unità di Neuroradiologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.3. Unità di Diagnostica per Immagini, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.Ematologia, Fondazione Policlinico Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata; Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA. Viale Oxford 81, 00133, Roma, ItaliaEmatologia, Fondazione Policlinico Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia.1. Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Viale Oxford 81, 00133, Roma, Italia. Background and objectives Identification of latent tuberculosis infection (LTBI) is a critical step of tuberculosis surveillance, especially in low incidence countries, and is limited to situations with a higher probability of developing active disease, e.g., patients with hematological malignancies. According to guidelines, in TB non-endemic countries no clear screening program is established at diagnosis for patients with acute leukemia (AL). The primary endpoint of this study was to establish the LTBI incidence in patients with diagnosis of AL using QuantiFERON (QFT)-TB. Secondarily, TB-specific prophylaxis efficacy and safety, and features driving increased risk of LTBI were evaluated. Methods QFT-TB screening was performed before induction, consolidation or during follow-up, in all patients with AL (myeloid and lymphoid), treated at our Institution between October 2019 and August 2023. Results We accrued 62 patients, of whom 7 (11,3%) tested positive, without any symptoms or signs of active TB, and 2 (3,2%) resulted as indeterminate. All positive patients started prophylaxis with isoniazid 300 mg/die, while patients whose test was indeterminate did not receive any prophylaxis. Active TB was excluded by imaging, as well as microscopic, cultural, and molecular examination on bronchoalveolar lavage. During the 46-month period of observation, none of the patients developed TB reactivation. Conclusions In our country, LTBI is not uncommon as expected. Despite the low sample size, 1 out of 10 of our patients had prior TB exposure. This finding suggests implementing TB screening in the pre-treatment setting, particularly in a time when more numerous active treatments are becoming available also for patients ineligible to intensive chemotherapy. https://www.mjhid.org/mjhid/article/view/5662Acute Leukemiatubercolosislatent tuberculosis infectionprophylaxisAcute Myeloid LeukemiaAcute Lymphoblastic Leukemia |
| spellingShingle | Andrea Nunzi Luigi Della Valle Elisa Linnea Lindfors Rossi Giorgia Ranucci Flavia Mallegni Federico Moretti Elisa Meddi Luca Guarnera Ilaria Tiravanti Kristian Taka Elisa Buzzatti Fabiana Esposito Roberto Secchi Francesca Di Giuliano Flavia Chirico Raffaele Palmieri Luca Maurillo Francesco Buccisano Carmelo Gurnari Giovangiacinto Paterno Adriano Venditti Maria Ilaria Del Principe ACUTE LEUKEMIA AND LATENT TUBERCULOSIS INFECTION IN ITALY: QUANTIFERON-TB TEST SCREENING IN A LOW TUBERCULOSIS INCIDENCE COUNTRY Mediterranean Journal of Hematology and Infectious Diseases Acute Leukemia tubercolosis latent tuberculosis infection prophylaxis Acute Myeloid Leukemia Acute Lymphoblastic Leukemia |
| title | ACUTE LEUKEMIA AND LATENT TUBERCULOSIS INFECTION IN ITALY: QUANTIFERON-TB TEST SCREENING IN A LOW TUBERCULOSIS INCIDENCE COUNTRY |
| title_full | ACUTE LEUKEMIA AND LATENT TUBERCULOSIS INFECTION IN ITALY: QUANTIFERON-TB TEST SCREENING IN A LOW TUBERCULOSIS INCIDENCE COUNTRY |
| title_fullStr | ACUTE LEUKEMIA AND LATENT TUBERCULOSIS INFECTION IN ITALY: QUANTIFERON-TB TEST SCREENING IN A LOW TUBERCULOSIS INCIDENCE COUNTRY |
| title_full_unstemmed | ACUTE LEUKEMIA AND LATENT TUBERCULOSIS INFECTION IN ITALY: QUANTIFERON-TB TEST SCREENING IN A LOW TUBERCULOSIS INCIDENCE COUNTRY |
| title_short | ACUTE LEUKEMIA AND LATENT TUBERCULOSIS INFECTION IN ITALY: QUANTIFERON-TB TEST SCREENING IN A LOW TUBERCULOSIS INCIDENCE COUNTRY |
| title_sort | acute leukemia and latent tuberculosis infection in italy quantiferon tb test screening in a low tuberculosis incidence country |
| topic | Acute Leukemia tubercolosis latent tuberculosis infection prophylaxis Acute Myeloid Leukemia Acute Lymphoblastic Leukemia |
| url | https://www.mjhid.org/mjhid/article/view/5662 |
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