Introduction: Tuberculosis (TB), an endemic and often neglected disease in Peru, has been hypothesized to contribute to carcinogenesis, particularly in lung cancer. However, its correlation with T-cell malignancies remains poorly understood. This study investigates the risk of TB infection in mature T-cell and NK-cell (MTNK) neoplasms from a high TB prevalence region.
Methods: We conducted a pooled analysis of multiple cancer registries, including 718 cases of aggressive MTNK neoplasms diagnosed between 2010 and 2020. The lifetime prevalence rate ratio (PRR) and incidence rate ratio (IRR) were assessed using a generalized Poisson model, with solid tumors as the reference group.
Results: Among 4,266 cancer cases evaluated, patients with lymphoid mature neoplasms associated with HTLV-1 infection-specifically Adult T-cell Leukemia/Lymphoma (ATLL), Hodgkin Lymphoma (HL), and Diffuse Large B-cell Lymphoma (DLBCL)-exhibited significantly higher PRR compared to solid tumors (2.7, 7.1, and 3.3, respectively). In addition, the IRR for aggressive MTNK neoplasms was significantly increased for ATLL (IRR = 7.62, p < 0.001) and Extranodal NK/T-cell Lymphoma (ENKTL) (IRR = 5.14, p = 0.015), but not for Peripheral T-cell Lymphoma (PTCL) cases. Among ATLL cases, 6 out of 8 patients with active TB experienced treatment delays of more than one month. However, despite the generally poor survival outcomes observed in ATLL, ENKTL, and PTCL (6.6, 8.9, and 11 months, respectively), no significant differences in survival were found based on the presence of TB infection.
Conclusions: This study provides initial evidence of an increased risk of TB coinfection among HTLV-1-associated lymphomas in Peru.
