Mycobacterial infections in adults with haematological malignancies and haematopoietic stem cell transplants: guidelines from the 8th European Conference on Infections in Leukaemia.

Mycobacterial infections, both tuberculosis and nontuberculous, are more common in patients with haematological malignancies and haematopoietic stem cell transplant recipients than in the general population-although these infections remain rare. Mycobacterial infections pose both diagnostic and therapeutic challenges. The management of mycobacterial infections is particularly complicated for patients in haematology because of the many drug-drug interactions between antimycobacterial drugs and haematological and immunosuppressive treatments. The management of mycobacterial infections must also consider the effect of delaying haematological management. We surveyed the management practices for latent tuberculosis infection (LTBI) in haematology centres in Europe. We then conducted a meticulous review of the literature on the epidemiology, diagnosis, and management of LTBI, tuberculosis, and nontuberculous mycobacterial infections among patients in haematology, and we formulated clinical guidelines according to standardised European Conference on Infections in Leukaemia (ECIL) methods. In this Review, we summarise the available literature and the recommendations of ECIL 8 for managing mycobacterial infections in patients with haematological malignancies.

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Declaration of interests CL reports funding from German Center of Infection Research (DZIF). DG reports consultancy and lectures for Amgen, Biogen, Biomerieux, Cellgene, Diasorin, Eli Lilly, Janssen, PBD Biotech, Qiagen, Quidel. DG reports funding from the Italian Ministry of Health (Ricerca Corrente Linea 4). All other authors declare no competing interests. The eighth ECIL meeting (Sept 19–21, 2019) was supported by unrestricted educational grants of Basilea Pharmaceuticals, Cidara Therapeutics, F2G, Gilead Sciences, Merck Sharp and Dohme, and Takeda. Basilea Pharmaceuticals, Cidara Therapeutics, F2G, Gilead Sciences, Merck Sharp and Dohme, and Takeda had no role in the selection of experts and the design of the guideline, in the collection, analysis, and interpretation of the data at any time including the consensus conference, or in the writing and editing of the guideline and in the decision to submit it for publication.