Tuberculosis in patients with malignant neoplasms of various localizations – the experience of the Central Research Institute of Tuberculosis

The aim of the study was to analyze the spectrum of clinical forms of respiratory tuberculosis (RTB) in patients with malignant neoplasms (MN), determine the relationship between the oncological course and treatment period, and assess the relative risk of developing RTB within this cohort.
Methods. A single-center cohort study was conducted between 2018 and 2025 at the Central Research Institute of Tuberculosis including 61 patients with verified RTB and MN. A comprehensive diagnostic algorithm was used, including clinical laboratory examination, imaging, TB immunodiagnostics, microbiological, and molecular genetic methods.
Results. In 90.2% of cases, malignant neoplasms had extrathoracic localization; the most common were breast cancer (36.1%), lymphomas (16.5%) and gastrointestinal tumors (14.8%). Among the clinical forms of RTB, infiltrative (29.5%), focal (24.6%) TB and TB of the intrathoracic lymph nodes (13.1%) prevailed. Relapse of TB was registered in 49.2% of patients. In 60.7% of patients, RTB was diagnosed during the period of remission of malignant neoplasms after completion of antitumor therapy. The highest relative risk of developing RTB was associated with combined chemo- and radiation therapy: RR = 2.8 compared with radiation therapy, RR = 2.3 compared with chemotherapy and RR = 2.5 compared with surgical treatment (p< 0.05). Before starting antitumor treatment, not a single patient was consulted by a TB specialist.
Conclusion. Patients with malignant neoplasms, especially that receiving combination anticancer therapy, represent a high-risk group for the development and recurrence of tuberculosis, including during cancer remission. Integration of oncology and phthisiology services, the implementation of mandatory tuberculosis screening before anticancer therapy, and individualized monitoring algorithms are necessary to facilitate early TB diagnosis, timely initiation of treatment and an improved prognosis in patients with comorbidities.

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