Specific Features of Detection and Course of Tuberculosis in Children and Adolescents with Malignant Neoplasms

The objective: to study detection and clinical and radiological characteristics of tuberculosis in children and adolescents with malignant diseases.

Subjects and Methods. Medical records of 105 children with respiratory tuberculosis (RTB) aged from 6 months to 17 years inclusive, examined in 2018–2025, were analyzed. Children were divided into two groups: Main Group (MG) – children with respiratory tuberculosis (RTB) and malignant neoplasms (MN) (52 patients) and Control Group (CG) – children with RTB and no MN (53 patients). Demographic characteristics, features of clinical manifestations and forms of respiratory tuberculosis of the patients were retrospectively analyzed.

Results. In 73.1% (38/52) of cases, respiratory tuberculosis in children from MG was detected during the onset of malignant neoplasms or their treatment, in 17.3% (9/52) – at the stage of malignant neoplasm remission, in 9.6% – at the stage of post-tuberculosis changes in the form of calcifications in the intrathoracic lymph nodes prior to development of malignant neoplasms. In MG, tuberculosis was detected in 59.6% (31/52) of patients with hemoblastoses and 40.4% (21/52) of patients with malignant neoplasms of solid organs. In children from MG, tuberculosis was detected in 21.2% (11/52) of cases based on the results of immunodiagnostics and in 78.8% (41/52) when they referred for help with complaints. In children from MG, the course of respiratory tuberculosis was characterized by a widespread disease (78.8%, 41/52) and development of bronchopulmonary complications (80.8%, 42/52). Among children with hemoblastoses, generalized or disseminated forms of tuberculosis were in 32.3% (10/31) of cases, in children with malignant neoplasms of solid organs – in 9.5% (2/21). The incidence of lesions of central nervous system in children from MG made 7.7% (4/52).

1. Aksenova V.A. Tuberculosis epidemiology in children. Current Problems of Health Care and Medical Statistics, 2019, no. 1, pp. 8-36. (In Russ.) https://doi.org/10.24411/2312-2935-2019-10002

2. Aksenova V.A., Gordina A.V., Sterlikov S.A., Kudlay D.A., Kucheryavaya D.A., Doctorova N.P. Impact of active case finding on clinical structure and severity of tuberculosis in school-aged children (7-15 years old). Tuberculosis and Lung Diseases, 2022, vol. 100, no. 1, pp. 26-32. (In Russ.) https://doi.org/10.21292/2075-1230-2022-100-1-26-32

3. Aksenova V.A., Klevno N.I., Kazakov A.V., Kudlay D.A., Sevostyanova T.A., Dementieva E.K. Preventive tuberculosis services reduces the risk of local forms of tuberculosis development in children on immunosuppressive therapy: retrospective cohort study. Voprosy Sovremennoy Pediatrii, 2020, vol. 19, no. 5, pp. 346-351. (In Russ.) https://doi.org/10.15690/vsp.v19i5.2210

4. Kulikova I.B., Vasilyeva I.A., Kazakov A.V., Klevno N.I., Sterlikov S.A., Kucheryavaya D.A., Lovacheva O.V., Andreeva T.V. Tuberculosis situation in pediatric population of the Russian Federation upon the end of the COVID-19 pandemic. Tuberculosis and Lung Diseases, 2025, vol. 103, no. 3, pp. 8-16. (In Russ.) http://doi.org/10.58838/2075-1230-2025-103-3-8-16

5. Ovsyankina E.S., Panova L.V., Zakharova I.N., Piskunova O.A. Comorbid conditions in phthisiology: the basis of interdisciplinary collaboration between pediatricians and phthisiologists (literature review and commentaries). Meditsinsky Soviet, 2024, vol. 18, no. 19, pp. 178-186. (In Russ.) https://doi.org/10.21518/ms2024-412

6. Orlov S.A., Kalinina A.M., Savchenko D.O., Voshev D.V. et al. Pervichnaya medikosanitarnaya pomoshch, obshchestvennoye zdorovye i organizatsiya zdravookhraneniya. Spravochnik ponyatiy i terminov. [Primary health care, public health, and healthcare organization. A reference guide to concepts and terms]. Moscow, ROPNIZ, OOO Silitseya-Poligraf Publ., 2023. https://doi.org/10.15829/ROPNIZ-k1-2023

7. Popova N.N., Savchenko V.G. Reconstitution of T-cell-mediated immunity in patients after allogeneic stem cell transplantation. Russian Journal of Hematology and Transfusiology, 2020, vol. 65, no. 1, pp. 21-38. (In Russ.) https://doi.org/10.35754/0234-5730-2020-65-1-24-38

8. Slogotskaya L.V., Lovacheva O.V., Klevno N.I. Stages of tuberculosis infection, what's new? (Literature review). Tuberculosis and Lung Diseases, 2025, vol. 103, no. 2, pp. 93-101. (In Russ.) http://doi.org/10.58838/2075-1230-2025-103-293-101

9. Solopova G.G., Novichkova G.A. Implementation of the algorithm of empirical antibacterial therapy for febrile neutropenia in the Сenter of Pediatric Hematology/Oncology. Pediatric Hematology/Oncology and Immunopathology, 2017, vol. 16, no. 3, pp. 35-47. (In Russ.) https://doi.org/10.24287/1726-1708-2017-16-3-35-47

10. Stogova N.A. Clinical and morphological aspects of the combination of tuberculosis and lung cancer. Voprosy Onkologii, 2022, vol. 68, no. 1, pp. 75-79. (In Russ.) https://doi.org/10.37469/0507-3758-2022-68-1-75-79

11. Tuberkulez u detey. Klinicheskie rekomendatsii. [Tuberculosis in children: Guidelines]. Ministerstvo zdravookhraneniya Rossiyskoy Federatsii Publ., 2024. Available: https://rof-tb.ru/upload/iblock/a34/ens4ys2ldl7tc0d3s1eo05rcvdiv58hr.pdf Accessed December 10, 2025

12. Adrover J.M., Mc.Dowell S.A.C, He X.Y., Quail D.F., Egeblad M. NETworking with cancer: The bidirectional interplay between cancer and neutrophil extracellular traps. Cancer Cell., 2023, vol.

13. Al-Anazi K.A., Al-Jasser A.M., Al-Anazi W.K. Natural killer cells in patients with hematologic malignancies, solid tumors and in recipients of hematopoietic stem cell transplantation. J. Stem Cell Ther. Transplant., 2019, no. 3, pp. 031-055.

14. Analysis and use of health facility data: guidance for maternal, newborn, child and adolescent health programme managers. Geneva, World Health Organization, 2023. Licence: CC BY-NC-SA 3.0 IGO.

15. Bumbacea D., Arend S.M., Eyuboglu F., Fishman J.A., Goletti D., Ison M.G., Jones C.E., Kampmann B., Kotton C.N., Lange C., Ljungman P., Milburn H., Morris M.I., Muller E., Muñoz P., Nellore A., Rieder H.L., Sester U., Theodoropoulos N., Wagner D., Sester M. The risk of tuberculosis in transplant candidates and recipients: a TBNET consensus statement. Eur. Respir. J., 2012, vol. 40, no. 4, pp. 990-1013. https://doi.org/10.1183/09031936.00000712

16. Dobler C.C., Cheung K., Nguyen J., Martin A. Risk of tuberculosis in patients with solid cancers and haematological malignancies: a systematic review and meta-analysis. Eur. Respir. J., 2017, vol. 50, no. 2, pp. 1700157. https://doi.org/10.1183/13993003.00157-2017

17. Dubois M., Dixit A., Lamb G. Tuberculosis in pediatric solid organ and hematopoietic stem cell recipients. Glob. Pediatr. Health, 2021, vol. 15, no. 8, pp. 2333794X20981548. https://doi.org/10.1177/2333794X20981548

18. Framework for collaborative action on tuberculosis and comorbidities Geneva. World Health Organization, 2022, 88 p. ISBN 978-92-4-005505-6.

19. Implementing the end TB strategy: the essentials, 2022 update. Geneva, World Health Organization, 2022. Licence: CC BY-NC-SA 3.0 IGO.

20. Masselli G., De Angelis C., Sollaku S., Casciani E., Gualdi G. PET/CT in pediatric oncology. Am. J. Nucl. Med. Mol. Imaging, 2020, vol. 10, no. 2, pp. 83-94. PMID: 32419977.

21. Nolt D., Starke J.R. Tuberculosis infection in children and adolescents: testing and treatment. Pediatrics, 2021, vol. 148, no. 6, pp. e2021054663. https://doi.org/10.1542/peds.2021-054663

22. Philip M., Schietinger A. CD8+ T cell differentiation and dysfunction in cancer. Nat. Rev. Immunol., 2022, vol. 22, no. 4, pp. 209-223. https://doi.org/10.1038/s41577-021-00574-3

23. Thommen D.S., Schumacher T.N. T cell dysfunction in cancer. Cancer Cell., 2018, vol. 33, no. 4, pp. 547-562. https://doi.org/10.1016/j.ccell.2018.03.012

24. WHO Classification of Tumours Editorial Board. 2023. Paediatric Tumours: WHO Classification of Tumours, 5th ed., vol. 7, pp. 1-1228. Geneva, Switzerland, International Agency for Research on Cancer. ISBN: 978-92-832-4510-0.

25. WHO consolidated guidelines on tuberculosis. Module 6: tuberculosis and comorbidities, second edition. Geneva, World Health Organization, 2025. Licence: CC BY-NC-SA 3.0 IGO.

26. WHO, Evidence to decision framework. Appendix to the Guidelines on the management of latent tuberculosis infection. WHO/HTM/TB/2015.01. Geneva, World Health Organization, 2015. Available: https://iris.who.int/server/api/core/bitstreams/bb725a00-ea2a-4f91-93cd-0a91c4d0b924/content Accessed December 01, 2025

27. WHO, Global tuberculosis report, 2025. Geneva, World Health Organization, 2025. License: CC BY-NC-SA 3.0 IGO.