Impact of active pulmonary tuberculosis on overall survival among adult patients with B-cell non-Hodgkin lymphoma

Introduction: Patients with B-cell non-Hodgkin lymphoma (B-cell NHL) have an increased risk of developing active tuberculosis (TB) during treatment. Active pulmonary TB among patients with B-cell NHL often leads to poor outcomes. Objective: The primary objective was to compare the 3-year overall survival (OS) of patients with B-cell NHL and active pulmonary TB to those without active pulmonary TB. The secondary objective was to investigate the association of active pulmonary TB with mortality risk among patients with B-cell NHL. Materials and Methods: A retrospective cohort was conducted on patients with newly diagnosed B-cell NHL at Chiangrai Prachanukroh Hospital from January 2016 to December 2023. OS rates were estimated using the Kaplan-Meier method and compared between groups using the two-sided log-rank test. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk factors associated with mortality. Results: A total of 415 patients were enrolled, with a mean age of 58.96 years. Among them, 19 (4.58%) developed active pulmonary TB after their B-cell NHL diagnosis and during treatment. Patients with active pulmonary TB had significantly worse 3-year OS compared to those without active pulmonary TB (22.39% vs. 55.11%, p < 0.001). The median follow-up time was 89 weeks. Active pulmonary TB was associated with an increased risk of mortality (HR, 1.80, 95% CI, 1.01-3.21). Conclusion: Active pulmonary TB among adult patients with B-cell NHL is associated with worse survival outcomes and represents an independent risk factor for mortality.