Non-Hodgkin lymphoma risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]
Overview
The known risk factors in the development of Hodgkin's lymphoma are weakened immune system, autoimmune disorders, certain infections and previous cancer treatment. Other possible risk factors include family history of Non-Hodgkin lymphoma, exposure to pesticides, exposure to trichloroethylene, diet, obesity, hair dyes, and occupational exposures.
Risk Factors
The known risk factors in the development of Hodgkin's lymphoma are weakened immune system, autoimmune disorders, certain infections and previous cancer treatment. Other possible risk factors include family history of Non-Hodgkin lymphoma, exposure to pesticides, exposure to trichloroethylene, diet, obesity, hair dyes, and occupational exposures.[1]
| Known risk factors | Possible risk factors |
|---|---|
| Weakened immune system | Family history of Non-Hodgkin lymphoma |
| Autoimmune disorders | Exposure to pesticides |
| Certain infections | Exposure to trichloroethylene |
| Previous cancer treatment | Diet |
| Obesity | |
| Hair dyes | |
| Occupational exposures |
Known risk factors
Weakened immune system
- Congenital immune system damage
- Acquired immune system damage
- Congenital immune system damage
- Inherited immunodeficiency disorders are very rare, but acquired ones are a little more common
- Inherited disorders
- Severe combined immunodeficiency (SCID)
- X-linked lymphoproliferative disorder
- Acquired immune system damage
- Acquired disorders
- Common variable immunodeficiency (CVID)
- HIV and AIDS
- Immunosuppressant drugs for
- Organ transplant (such as a kidney, heart or liver transplant)
- Rheumatoid arthritis
- Inflammatory bowel disease
- Lupus
Autoimmune disorders
- Linked with marginal cell lymphoma
- Linked with diffuse large B-cell lymphoma
- Linked with diffuse large B-cell lymphoma
- Linked with lymphoplasmacytic lymphoma
- Linked with diffuse large B-cell lymphoma
- Linked with a higher risk for enteropathy-associated T-cell lymphoma (EATL)
- Linked with a higher risk of developing primary thyroid lymphoma
Certain infections
The following viral and bacterial infections can increase the risk of developing NHL. They may damage lymphocyteslymphocytesA type of white blood cell that fights viruses, bacteria, foreign substances or abnormal cells (including cancer cells). or constantly stimulate the immune system so it doesn’t work properly.
Epstein-Barr virus (EBV) is a type of herpes virus that causes infectious mononucleosis (also called mono, or the kissing disease). It is linked to Burkitt lymphoma and to lymphomas in people with a weakened immune system because of HIV/AIDS or immunosuppressant drugs. EBV is also linked to some other types of cancer. This virus and Burkitt lymphoma occur most commonly in Africa.
Human T-cell leukemia/lymphoma virus, type 1 (HTLV-1) increases the risk of developing adult T-cell lymphoma and leukemia. It is most common in southern Japan and the Caribbean.
Helicobacter pylori (H. pylori) is a type of bacteria that causes stomach ulcers and inflammation of the stomach lining (called gastritis). It is linked with gastric lymphomas, particularly a type of lymphoma that occurs in the stomach called mucosa-associated lymphoid-tissue (MALT) lymphoma. H. pylori also increases the risk of stomach cancer.
Kaposi sarcoma herpes virus (KSHV) is also called Human herpesvirus 8 (HHV-8). It is linked with primary effusion lymphoma, body cavity lymphomas and AIDS-related lymphomas.
Hepatitis C virus (HCV) and hepatitis B virus (HBV) are 2 of a group of viruses that can cause inflammation of the liver (called hepatitis). People with HCV or HBV infection have a higher risk of developing some types of NHL.
Campylobacter jejuni (C. jejuni) is a type of bacteria that can cause gastrointestinal (GI) infections. It is linked with a type of lymphoma called mucosa-associated lymphoid-tissue (MALT) lymphoma.
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Previous cancer treatment
People who have received chemotherapy, with or without radiation therapy, for another type of cancer have a higher risk of developing NHL. This is especially true for people who were treated for Hodgkin lymphoma. But the benefit of being treated for cancer usually far outweighs the risk of developing a second cancer.
The risk of developing NHL is greatest in the first 5 years after treatment. But people who have been treated for cancer have a higher risk of developing NHL for the rest of their lives.
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Possible risk factors
The following factors have been linked with NHL, but there is not enough evidence to show they are known risk factors. Further study is needed to clarify the role of these factors for NHL.
Family history of NHL
NHL is not generally considered to be familial, which means occurring in families more often than would be expected by chance. But some studies show a higher risk of NHL in people with a first-degree relative (a parent, brother, sister or child) who has been diagnosed with lymphoma. Further studies are needed to determine the risk of developing NHL when a first-degree relative has had the disease.
Exposure to pesticides
Pesticides include a large number of different chemicals, some of which may be related to NHL risk. Some studies suggest that exposure to certain pesticides, such as Agent Orange, may be linked with a higher risk of developing NHL. The evidence has not been consistent, so further research is needed to help clarify the possible link between pesticides and cancer, and to identify which ones may increase the risk of NHL.
Exposure to trichloroethylene
Trichloroethylene (TCE) is a solvent used mostly to remove grease from metal. Some studies suggest that exposure to TCE may increase the risk of developing NHL.
Diet
The link between NHL and diet is very complex. Researchers are trying to find out if diet may increase the risk for NHL. Some studies suggest that diets high in meat, dairy products and saturated fat may increase the risk of developing NHL. Other studies show that diets low in vegetables increase the risk of NHL.
Obesity
Some studies suggest that being obese may increase the risk of developing NHL, particularly large B-cell lymphoma.
Hair dyes
Studies have shown a higher risk of NHL in people who used hair dye before 1980. The chemical composition of hair dyes is different now than before 1980, and some of the harmful ingredients have been removed. The risk affects people who used permanent dyes with dark colours in particular. This risk may also be higher in hair dressers and barbers, who were exposed to the dye at work.
Occupational exposures
A number of studies suggest that people working in certain jobs have a higher risk of NHL. These occupations include farming, the rubber industry, wood and forestry, printing and welding. Researchers haven’t identified specific exposures to explain these risks. More research is needed.
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Unknown risk factors
It isn’t known whether or not exposure to ionizing radiation is linked with NHL. It may be that researchers can’t show a definite link or that studies have had different results. Further study is needed to see if ionizing radiation is a risk factor for NHL.
People who survived nuclear industry accidents or the atomic bombs used during World War II were exposed to large amounts of ionizing radiation. People who are treated with radiation therapy are exposed to smaller amounts of ionizing radiation. Medical imaging, such as x-rays, also uses very small doses of ionizing radiation.
The following are some of the risk factors associated with this disease:
- Age/sex. The likelihood of getting non-Hodgkin's lymphoma increases with age and is more common in men than in women.
- Weakened immune system (AIDS-related lymphoma). Non-Hodgkin's lymphoma is more common among people with inherited immune deficiencies, autoimmune diseases, or HIV/AIDS, and among people taking immunosuppressant drugs following organ transplants. (see Post-transplant lymphoproliferative disorder)
- Viruses. Human T-lymphotropic virus type I (HTLV-1) and Epstein-Barr virus are two infectious agents that increase the chance of developing non-Hodgkin's lymphoma.
- Environment. People who work extensively with or are otherwise exposed to certain chemicals, such as pesticides, solvents, or fertilizers, have a greater chance of developing non-Hodgkin's lymphoma.
People who are concerned about non-Hodgkin's lymphoma should talk with their doctor about the disease, the symptoms to watch for, and an appropriate schedule for checkups. The doctor's advice will be based on the person's age, medical history, and other factors.