Efficacy of Isoniazid Prophylaxis in Pediatric Patients at High Risk for LTBI Undergoing Hematopoietic Stem Cell Transplantation
By
Uet Yu
Jiaming Yu
Xindan Lian
Yu Liu
Xiaodong Wang
Qian Zhang
Chunjing Wang
Chunlan Yang
Yue Li
Xiaohui Zhou
Xiaoling Zhang
Sixi Liu
February 2, 2026
Clinical Scorecard: Efficacy of Isoniazid Prophylaxis in Pediatric Patients at High Risk for LTBI Undergoing Hematopoietic Stem Cell Transplantation
At a Glance
Category Detail
Condition Latent Tuberculosis Infection (LTBI) in pediatric HSCT recipients Key Mechanisms Immunosuppression post-HSCT increases TB reactivation risk Target Population Pediatric patients undergoing hematopoietic stem cell transplantation Care Setting Pediatric hematology/oncology units
Key Highlights
TB incidence in HSCT recipients is 10–40 times higher than the general population. Isoniazid (INH) prophylaxis significantly reduces post-HSCT TB reactivation. Effective TB risk stratification is essential for optimizing prophylaxis. Guideline-Based Recommendations
Diagnosis
Utilize IGRA tests and radiological assessments for TB risk stratification. Follow WHO guidelines for diagnosing active TB. Management
Administer INH at 5-10 mg/kg/d starting 5-7 days post-HSCT for high-risk patients. Monitoring & Follow-up
Conduct weekly follow-ups for the first three months post-HSCT, biweekly for the next three months, and monthly thereafter. Risks
Monitor for drug-related toxicities, particularly hepatic and renal functions. Patient & Prescribing Data
689 pediatric HSCT recipients, with 69 classified as LTBI high-risk.
INH prophylaxis is well-tolerated with careful monitoring for adverse effects.
Clinical Best Practices
Implement thorough pre-HSCT evaluations including IGRA and radiological assessments. Ensure multidisciplinary approaches for TB diagnosis in suspected cases. Related Resources & Content
