Risk and impact of tuberculosis in patients with chronic myeloid leukemia: A nationwide population-based study in Taiwan

Chia Jen Liu, Ying Chung Hong, Chung Jen Teng, Man Hsin Hung, Yu Wen Hu, Fan Chen Ku, Yung Tai Chen, Sheng Hsuan Chien, Chiu Mei Yeh, Tzeng Ji Chen, Tzeon Jye Chiou, Jyh Pyng Gau, Cheng Hwai Tzeng

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


The relationship between chronicmyeloid leukemia (CML) and tuberculosis (TB) has not been determined.We conducted a national survey including 1,082 CML patients identified fromthe Taiwan National Health Insurance database covering a period between 1998 and 2011; thematched non-exposed cohort included 10,820 subjects without CML that werematched for age, sex and comorbidities. The impact of TB was measured by the overall mortality, and the risk factors were identified by a multivariate Cox proportional hazards model. We found the risk of TB was higher in the CML cohort, with an adjusted hazard ratio (aHR) of 3.76 (p50.001) for both pulmonary (aHR 3.23, p < 0.001) and extrapulmonary (aHR 9.77, p50.001) TB. Specific risk factors were: aged ≥60 (aHR 3.24, p50.022), beingmale (aHR 13.49, p50.012), receiving stem cell transplantation (aHR 10.50, p50.001) and interferon-a therapy (aHR 3.34, p50.011). CML patients with TB had a higher mortality rate than those without (aHR 2.04, p50.043).We conclude that the incidence of TB is significantly higher in CML patients of male sex, aged≥60, having received either stem cell transplantation or interferon-a treatment. Careful screening strategies for TB should be considered for CML patients with high risk of the infection.

Original languageEnglish
Pages (from-to)1881-1887
Number of pages7
JournalInternational Journal of Cancer
Issue number8
Publication statusPublished - Apr 2015
Externally publishedYes


  • BCR-ABL tyrosine kinase inhibitors
  • Chronic myeloid leukemia
  • Extrapulmonary tuberculosis
  • Hematopoietic stem cell transplantation
  • Imatinib
  • Pulmonary tuberculosis

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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