The Mono-Hodgkin's Link

Mono And The Epstein-Barr Virus

It has long been suspected that there is a link between mononucleosis and Hodgkin's disease, which is a highly treatable form of cancer of the lymphatic system.

Mono is caused by a virus called Epstein-Barr and this virus has been found in more than half of Hodgkin's tumors. EPV has been implicated in many other types of cancers as well and while it is a cause of Hodgkin's disease, it is not THE cause of this particular cancer.

The Link Between EPV And Hodgkin's Disease

A study completed in Scandinavia reported an increase in the incidents of Hodgkin's disease in young people. Hodgkin's is the most common type of malignancy in people between the ages of 10 and 30, with the average age of developing the disease being 28 years of age.

There are two periods of time when HD (Hodgkin's disease) incidence peaks in a lifetime: one from 15 to 24 and the other after age 55.

It accounts for one percent of the cancers in the United States. The disease can, and does, appear in both younger and older age groups as well. In the elderly, Hodgkin's disease is more severe when associated with the Epstein-Barr virus than other forms of HD.

Young People Are Particularly At Risk

Young people who have been infected with EPV and mononucleosis are at higher risk for Hodgkin's disease than those who have not been infected.

According to a study completed in 2003, if HD does develop in a young person who has had mono, it will likely happen within four years of contracting the virus, with a peak time being two and a half years.

However, the risk continues for two decades. The research has indicated some sort of pathway that is activated by the virus within the lymphocyte cell which in turn leads to proliferation.

HD, also known as Hodgkin's lymphoma, is uncommon and about one in 1,000 young people who are infected with EBV through mono will develop the cancer.

It is important to note that Epstein-Barr virus is present in about 90 percent of the population and in the majority of cases it causes only a mild infection or none at all. Very few develop HD so it follows that other factors must be present to instigate a malignancy.

Knowledge Is Power

Parents and patients need not be overly concerned about the outcome of the study. Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer society said, "This doesn't change our practice or our patterns. It enhances our knowledge."

Dr. Richard Ambinder of Johns Hopkins School of Medicine said the research raises the possibility of preventing Hodgkin's in those who have had mono or diagnosing it earlier. "There's fertile ground for more research," he said.


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