Hamdi Akan

The Frequency of Tuberculosis in Adult Allogeneic Stem Cell Transplant Recipients in Turkey

In general, tuberculosis (Tb) is rarely seen in allogeneic stem cell transplant (alloSCT) recipients, but this observation has been challenged in developing countries such as Turkey, where Tb infection is more prevalent than in Europe and the US. In this retrospective study, we report on the incidence of Tb infections in 351 alloSCT recipients at 4 bone marrow transplantation units in Turkey over the last 10 years. The frequency of Tb in alloSCT recipients after allografting (5 of 351) was far greater than that in the general population (35.4 per 100,000). Of the 351 patients who underwent alloSCT, 77 who received isoniazid (INH) chemoprophylaxis for 6 months did not develop posttransplantation Tb. However, 5 of the remaining 274 patients who received no chemoprophylaxis developed Tb a median of 12 months (range, 10-47 months) after allografting. Antituberculosis therapy resulted in complete recovery in all cases. In 2 additional patients who were found to have active pulmonary Tb at the time of transplantation, alloSCT was delayed until the infections were treated. Infections of mycobacteria other than Mycobacterium tuberculosis were not observed. The number of patients who received and tolerated INH may not be sufficient for firm conclusions, but the data suggest that, in countries where Tb is prevalent, pre- and posttransplantation follow-up for Tb and the use of INH prophylaxis should be considered.

Allojeneik hematopoietik hücre naklinde gözlenen tiroid fonksiyon bozuklukları Thyroid dysfunction after allogeneic hematopoietic stem cell transplantation

Dr. Bilge Ceydilek Kısıklı sok. 4/6 Akdere-Ankara Tel : (505) 263 58 53 E-posta adresi : bilge_ceydilek@mynet.com Geliş tarihi: 31.08.2005 • Kabul tarihi: 07.04.2006 A llojeneik hematopoietik hücre nakli (AHHN) ülkemizde hematolojik malignitelerin tedavisinde hem erişkin, hem de çocuk hastalarda kullanılmakta olan bir yöntemdir. Bu işlemde kullanılan yüksek doz kemoterapi ve/veya tüm vücut ışınlama yöntemi tüm organ sistemlerini etkileyebilmektedir. Endokrin bezlerde klinik veya subklinik birçok etki beklenebilir. Hematopoietik hücre nakli uygulanan hastalarda tiroid fonksiyonlarındaki değişiklikler bugüne kadar pek çok çalışmada incelenmiştir. Çoğu seride en sık görülen durumlar hipotiroidizm ve hasta ötiroid sendromu olarak kaydedilmiştir. Bu çalışmadaki amacımız AHHN uygulanan hastalarımızda nakil sonrası dönemde gelişebilen tiroid fonksiyon bozukluklarını tanımlamaktır.