Tuberc Respir Dis > Volume 58(3); 2005 > Article
Tuberculosis and Respiratory Diseases 2005;58(3):285-290.
DOI: https://doi.org/10.4046/trd.2005.58.3.285    Published online March 1, 2005.
Characteristics of Tuberculosis Detected during Chemotherapy for a Solid Tumor.
Deog Kyeom Kim, Sei Won Lee, Young Ae Kang, Young Soon Yoon, Chul Gyoo Yoo, Young Whan Kim, Sung Koo Han, Young Soo Shim, Jae Joon Yim
Division of Respiratory and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea. yimjj@snu.ac.kr
Abstract
BACKGROUND
Some malignancies including lymphoma, head and neck cancer, and lung cancer are believed to be associated with the reactivation of tuberculosis (TB) because cyclic anti-cancer chemotherapy can induce the leukopenia or immunological deterioration. This report describes the clinical characteristics and treatment response of TB that developed during cyclic anti-cancer chemotherapy in patients with a solid tumor. MATERIALS AND METHODS: From January 1 2000 to July 31 2004, patients with TB diagnosed microbiologically, pa?thologically, or clinically during anti-cancer chemotherapy in a tertiary hospital were enrolled, and their medical records were reviewed. Patients with the known risk factors for the reactivation of TB were excluded. RESULTS: Twenty-two patients were enrolled and their mean age was 56.5 years (range 21-78). The male to female ratio was 3.4:1 and pulmonary TB was the main variant (20 patients, 90.9%). Gastric cancer (10 patients, 45.4%) and lymphoma (4 patients, 18.2%) were the leading underlying malignancies. The other malignancies included lung cancer, head and neck cancer, breast cancer, cervix cancer, and ovary cancer. Fifteen patients (68.2%) had a healed scar on a simple chest radiograph suggesting a previous TB infection. Among these patients, new TB lesions involved the same lobe or the ipsilateral pleura in 13 patients (87.6%). An isoniazid and rifampicin based regimen were started in all the subjects except for one patient with a hepatic dysfunction. The mean duration of medication was 9.9 +/- 2.4 months and no adverse events resulting in a regimen change were observed. With the exception of 5 patients who died of the progression of the underlying malignancy, 70.6% (12/17) completed the anti-TB treatment. CONCLUSION: The clinical characteristics and response to anti-TB treatment for TB that developed during anti- cancer chemotherapy for a solid tumor were not different from those of patients who developed TB in the general population.
Key Words: Tuberculosis, Chemotherapy, Reactivation, Cancer


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