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Purpose: To identify factors associated with lymphoma in patients with anterior Mycobacterium tuberculosis (TB).
Methods: A retrospective case-control analysis was performed in a highly tuberculosis-endemic area. TB-infected patients were retrospectively identified when a history of TB exists before the diagnosis of lymphoma. Inpatients with lymphoma (n=1,057) and benign tumors (n=12,916) were consecutively enrolled at Xinjiang Medical University Cancer Hospital between January 2016 and December 2019.
Results: The proportion of TB in patients with lymphoma (n=148, 14.0%) was significantly higher than that in the control (benign tumor) group (n=175, 1.4%) (p<0.0001). The frequency of TB infection in patients with Hodgkin’s lymphoma, B-cell non-Hodgkin’s lymphoma (NHL), and T/NK-cell NHL is 13.6%, 14.6%, and 11.9%, respectively. Compared to other subtypes of B-cell NHL, a relatively high proportion of tuberculosis was found in patients with chronic lymphocytic leukemia /small lymphocytic lymphoma, marginal zone B-cell lymphoma, diffuse large B-cell lymphoma, corresponding to 20.6%, 18.6% and 15.3%, respectively. For T-cell NHL, the proportion of TB infection in patients with peripheral T-cell lymphoma and anaplastic lymphoma kinase-positive T-cell NHL was 26.1% and 20%, respectively. Multivariate analysis revealed male gender as an adverse risk factor was associated with lymphoma after tubercular infection. In addition, male gender and old age (>60 years) was associated with the B-cell NHL.
Conclusion: A high proportion of Mycobacterium tuberculosis infection was found in patients with lymphoma. In TB-infected patients, older age and male gender are associated with susceptibility to lymphoma, suggesting the awareness of a screening program might be useful for early detection of lymphoma.