T-SPOT.TB for Detection of Tuberculosis Infection among Hematological Malignancy Patients and Hematopoietic Stem Cell Transplant Recipients

Abstract

The diagnosis of latent Mycobacterium tuberculosis infection (LTBI) is recommended in hematologicalmalignancy patients and before hematopoietic stem cell transplantation (Guidelines for the prevention andmanagement of infectious complications of solid organ transplantation, 2004). Compared to traditional methodssuch as tuberculin skin test (TST), T-SPOT.TB has been shown to be more specific. In the present study weenrolled 536 patients for whom T-SPOT.TB was performed, among which 295 patients also received the TSTtest. The agreement (79%) between T-SPOT.TB and TST was poor (κ=0.274, P<0.001). The patients with positiveT-SPOT.TB results numbered 62 (11.6%), in which only 20 (48.8%) of the 41 receiving the TST test had positiveresults. A majority of the patients with T-SPOT.TB positive results had some other evidence ofTB, such as TBhistory, clinical symptoms and an abnormal chest CT scan. Active TB was found in 9 patients, in which 2 hadnegative TST results. We followed up the patients and no one developed active TB. Our study suggested that theT-SPOT.TB may be more useful for screening LTBI and active TB in hematological malignancy patients andhematopoietic stem cell transplant recipients than the TST test.