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We conducted a nested case control study to investigate the incidence and risk factors for TB after allo-HSCT. Between 2012 and 2017, 730 consecutive allo-HSCT recipients were enrolled, and 14 patients (1.92%) were diagnosed with TB.\u00a0Relatively, 54 allo-HSCT recipients were selected as control. Patients who suffered TB had a significantly higher 3-year non-relapse mortality rate than the control group (30.36% vs 5.39%, P\u2009&lt;\u20090.01). In multivariate analysis, invasive fungal disease (HR 4.87, 95% CI 1.39\u201317.09), treatment with a relatively high dose of prednisone (HR 10.34, 95% CI 1.12\u201395.47) and treatment with tacrolimus (HR 4.79, 95% CI 1.18\u201319.44) were identified independent risk factors for TB occurrence post allo-HSCT (P\u2009&lt;\u20090.05).\u00a0Meanwhile, donor type, dose and type of anti-thymocyte globulin (ATG) administrated, as well as treatment intensity, did not alter the incidence of TB. Therefore, allo-HSCT recipients with unexplained fever, especially those who suffer from invasive fungal disease and ongoing immunosuppression with a relatively high dose of prednisone or tacrolimus, are at a high-risk of developing active TB.\u00a0Closely Monitoring TB occurrence, making a timely diagnosis and administering the proper treatment may be beneficial to those high-risk patients.<\/jats:p>","DOI":"10.1038\/s41598-019-56013-w","type":"journal-article","created":{"date-parts":[[2019,12,31]],"date-time":"2019-12-31T11:02:45Z","timestamp":1577790165000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Allo-HSCT recipients with invasive fungal disease and ongoing immunosuppression have a high risk for developing tuberculosis"],"prefix":"10.1038","volume":"9","author":[{"given":"Apeng","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimin","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3706-4959","authenticated-orcid":false,"given":"Yishan","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yamin","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanmin","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,12,31]]},"reference":[{"key":"56013_CR1","doi-asserted-by":"publisher","first-page":"1765","DOI":"10.1016\/S0140-6736(13)62078-4","volume":"382","author":"A Zumla","year":"2013","unstructured":"Zumla, A., George, A., Sharma, V. & Herbert, N. 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