Non-Hodgkin's Lymphoma After Treatment of Hodgkin's Disease: Association with Epstein-Barr Virus

  1. ALAN F. LIST, M.D.;
  2. JOHN P. GREER, M.D.;
  3. JOHN B. COUSAR, M.D.;
  4. RICHARD S. STEIN, M.D.;
  5. JOHN M. FLEXNER, M.D.;
  6. FARUK SINANGIL, Ph.D.;
  7. JACK DAVIS, B.Sc.;
  8. DAVID J. VOLSKY, Ph.D.; and
  9. DAVID T. PURTILO, M.D.
  1. Nashville, Tennessee; and Omaha, Nebraska

    Abstract

    Non-Hodgkin's lymphoma occurs infrequently as a late complication of obscure cause after treatment of Hodgkin's disease. We investigated the possible role of Epstein-Barr virus in the pathogenesis of such secondary malignancies of B-cell lineage. Two patients, aged 25 and 43 years, developed high-grade non-Hodgkin's lymphomas 12 and 8 years after radiation therapy for Hodgkin's disease. Serologic profiles in these patients showed evidence of acute and past Epstein-Barr virus infections, respectively. Molecular hybridization analysis showed the presence of multiple cellular equivalents of virus genome in tumor specimens from each patient. Our findings suggest that Epstein-Barr virus may play an integral role in the pathogenesis of non-Hodgkin's lymphoma of B-cell lineage that develops after treatment of Hodgkin's disease.

    Article and Author Information

    • ▸From the Divisions of Hematology and Hematopathology, Vanderbilt University Medical Center, Nashville, Tennessee; and the Department of Pathology, University of Nebraska Medical Center, Omaha, Nebraska.

    • Grant support: in part by grants CA30196 from the National Cancer Institute, LB506 from the Nebraska Department of Health, and a grant from the Lymphoproliferative Fund.

    • ▸Requests for reprints should be addressed to John P. Greer, M.D.; Division of Hematology, Room C-3119, MCN, Vanderbilt University Medical Center; Nashville, TN 37232.

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    1. Ann Intern Med November 1, 1986 vol. 105 no. 5 668-673
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