Characteristics of Hodgkin's lymphoma after infectious mononucleosis.

Henrik Hjalgrim; Johan Askling; Klaus Rostgaard; Stephen Hamilton-Dutoit; Morten Frisch; Jin-Song Zhang; Mette Madsen; Nils Rosdahl; Helle Bossen Konradsen; Hans H Storm; Mads Melbye

doi:10.1056/NEJMoa023141

Characteristics of Hodgkin's lymphoma after infectious mononucleosis.

Henrik Hjalgrim, Johan Askling, Klaus Rostgaard, Stephen Hamilton-Dutoit, Morten Frisch, Jin-Song Zhang, Mette Madsen, Nils Rosdahl, Helle Bossen Konradsen, Hans H Storm, Mads Melbye

Department of Public Health

282 Citations (Scopus)

Abstract

BACKGROUND: Infectious mononucleosis-related Epstein-Barr virus (EBV) infection has been associated with an increased risk of Hodgkin's lymphoma in young adults. Whether the association is causal remains unclear. METHODS: We compared the incidence rates of Hodgkin's lymphoma in two population-based Danish cohorts of patients who were tested for infectious mononucleosis: 17,045 with serologic evidence of having had acute EBV infection, and 24,614 with no such evidence. We combined the cohort of patients who had serologically verified infectious mononucleosis with a cohort of 21,510 Swedish patients with infectious mononucleosis (combined total, 38,555). Biopsy specimens of Hodgkin's lymphomas occurring during follow-up in this combined cohort were tested serologically for the presence of EBV. Using this information, we modeled the relative risk of EBV-negative and EBV-positive Hodgkin's lymphoma in different periods after the diagnosis of infectious mononucleosis and estimated the median incubation time for mononucleosis-related EBV-positive Hodgkin's lymphoma. RESULTS: Only serologically confirmed infectious mononucleosis was associated with a persistently increased risk of Hodgkin's lymphoma. Sixteen of 29 tumors (55 percent), obtained from patients with infectious mononucleosis, had evidence of EBV. There was no evidence of an increased risk of EBV-negative Hodgkin's lymphoma after infectious mononucleosis. In contrast, the risk of EBV-positive Hodgkin's lymphoma was significantly increased (relative risk, 4.0; 95 percent confidence interval, 3.4 to 4.5). The estimated median incubation time from mononucleosis to EBV-positive Hodgkin's lymphoma was 4.1 years (95 percent confidence interval, 1.8 to 8.3). CONCLUSIONS: A causal association between infectious mononucleosis-related EBV infection and the EBV-positive subgroup of Hodgkin's lymphomas is likely in young adults.
Udgivelsesdato: 2003-Oct-2

Original language	English
Journal	New England Journal of Medicine
Volume	349
Issue number	14
Pages (from-to)	1324-32
Number of pages	8
ISSN	0028-4793
DOIs	https://doi.org/10.1056/NEJMoa023141
Publication status	Published - 2003

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@article{b8e5ea70001d11ddbee902004c4f4f50,

title = "Characteristics of Hodgkin's lymphoma after infectious mononucleosis.",

abstract = "BACKGROUND: Infectious mononucleosis-related Epstein-Barr virus (EBV) infection has been associated with an increased risk of Hodgkin's lymphoma in young adults. Whether the association is causal remains unclear. METHODS: We compared the incidence rates of Hodgkin's lymphoma in two population-based Danish cohorts of patients who were tested for infectious mononucleosis: 17,045 with serologic evidence of having had acute EBV infection, and 24,614 with no such evidence. We combined the cohort of patients who had serologically verified infectious mononucleosis with a cohort of 21,510 Swedish patients with infectious mononucleosis (combined total, 38,555). Biopsy specimens of Hodgkin's lymphomas occurring during follow-up in this combined cohort were tested serologically for the presence of EBV. Using this information, we modeled the relative risk of EBV-negative and EBV-positive Hodgkin's lymphoma in different periods after the diagnosis of infectious mononucleosis and estimated the median incubation time for mononucleosis-related EBV-positive Hodgkin's lymphoma. RESULTS: Only serologically confirmed infectious mononucleosis was associated with a persistently increased risk of Hodgkin's lymphoma. Sixteen of 29 tumors (55 percent), obtained from patients with infectious mononucleosis, had evidence of EBV. There was no evidence of an increased risk of EBV-negative Hodgkin's lymphoma after infectious mononucleosis. In contrast, the risk of EBV-positive Hodgkin's lymphoma was significantly increased (relative risk, 4.0; 95 percent confidence interval, 3.4 to 4.5). The estimated median incubation time from mononucleosis to EBV-positive Hodgkin's lymphoma was 4.1 years (95 percent confidence interval, 1.8 to 8.3). CONCLUSIONS: A causal association between infectious mononucleosis-related EBV infection and the EBV-positive subgroup of Hodgkin's lymphomas is likely in young adults. Udgivelsesdato: 2003-Oct-2",

author = "Henrik Hjalgrim and Johan Askling and Klaus Rostgaard and Stephen Hamilton-Dutoit and Morten Frisch and Jin-Song Zhang and Mette Madsen and Nils Rosdahl and Konradsen, {Helle Bossen} and Storm, {Hans H} and Mads Melbye",

note = "Keywords: Adolescent; Adult; Aged; Antibodies, Viral; Child; Cohort Studies; Denmark; Female; Herpesvirus 4, Human; Hodgkin Disease; Humans; Incidence; Infectious Mononucleosis; Male; Middle Aged; Reed-Sternberg Cells; Risk; Sweden",

year = "2003",

doi = "10.1056/NEJMoa023141",

language = "English",

volume = "349",

pages = "1324--32",

journal = "New England Journal of Medicine",

issn = "0028-4793",

publisher = "Massachusetts Medical Society",

number = "14",

}

TY - JOUR

T1 - Characteristics of Hodgkin's lymphoma after infectious mononucleosis.

AU - Hjalgrim, Henrik

AU - Askling, Johan

AU - Rostgaard, Klaus

AU - Hamilton-Dutoit, Stephen

AU - Frisch, Morten

AU - Zhang, Jin-Song

AU - Madsen, Mette

AU - Rosdahl, Nils

AU - Konradsen, Helle Bossen

AU - Storm, Hans H

AU - Melbye, Mads

N1 - Keywords: Adolescent; Adult; Aged; Antibodies, Viral; Child; Cohort Studies; Denmark; Female; Herpesvirus 4, Human; Hodgkin Disease; Humans; Incidence; Infectious Mononucleosis; Male; Middle Aged; Reed-Sternberg Cells; Risk; Sweden

PY - 2003

Y1 - 2003

N2 - BACKGROUND: Infectious mononucleosis-related Epstein-Barr virus (EBV) infection has been associated with an increased risk of Hodgkin's lymphoma in young adults. Whether the association is causal remains unclear. METHODS: We compared the incidence rates of Hodgkin's lymphoma in two population-based Danish cohorts of patients who were tested for infectious mononucleosis: 17,045 with serologic evidence of having had acute EBV infection, and 24,614 with no such evidence. We combined the cohort of patients who had serologically verified infectious mononucleosis with a cohort of 21,510 Swedish patients with infectious mononucleosis (combined total, 38,555). Biopsy specimens of Hodgkin's lymphomas occurring during follow-up in this combined cohort were tested serologically for the presence of EBV. Using this information, we modeled the relative risk of EBV-negative and EBV-positive Hodgkin's lymphoma in different periods after the diagnosis of infectious mononucleosis and estimated the median incubation time for mononucleosis-related EBV-positive Hodgkin's lymphoma. RESULTS: Only serologically confirmed infectious mononucleosis was associated with a persistently increased risk of Hodgkin's lymphoma. Sixteen of 29 tumors (55 percent), obtained from patients with infectious mononucleosis, had evidence of EBV. There was no evidence of an increased risk of EBV-negative Hodgkin's lymphoma after infectious mononucleosis. In contrast, the risk of EBV-positive Hodgkin's lymphoma was significantly increased (relative risk, 4.0; 95 percent confidence interval, 3.4 to 4.5). The estimated median incubation time from mononucleosis to EBV-positive Hodgkin's lymphoma was 4.1 years (95 percent confidence interval, 1.8 to 8.3). CONCLUSIONS: A causal association between infectious mononucleosis-related EBV infection and the EBV-positive subgroup of Hodgkin's lymphomas is likely in young adults. Udgivelsesdato: 2003-Oct-2

AB - BACKGROUND: Infectious mononucleosis-related Epstein-Barr virus (EBV) infection has been associated with an increased risk of Hodgkin's lymphoma in young adults. Whether the association is causal remains unclear. METHODS: We compared the incidence rates of Hodgkin's lymphoma in two population-based Danish cohorts of patients who were tested for infectious mononucleosis: 17,045 with serologic evidence of having had acute EBV infection, and 24,614 with no such evidence. We combined the cohort of patients who had serologically verified infectious mononucleosis with a cohort of 21,510 Swedish patients with infectious mononucleosis (combined total, 38,555). Biopsy specimens of Hodgkin's lymphomas occurring during follow-up in this combined cohort were tested serologically for the presence of EBV. Using this information, we modeled the relative risk of EBV-negative and EBV-positive Hodgkin's lymphoma in different periods after the diagnosis of infectious mononucleosis and estimated the median incubation time for mononucleosis-related EBV-positive Hodgkin's lymphoma. RESULTS: Only serologically confirmed infectious mononucleosis was associated with a persistently increased risk of Hodgkin's lymphoma. Sixteen of 29 tumors (55 percent), obtained from patients with infectious mononucleosis, had evidence of EBV. There was no evidence of an increased risk of EBV-negative Hodgkin's lymphoma after infectious mononucleosis. In contrast, the risk of EBV-positive Hodgkin's lymphoma was significantly increased (relative risk, 4.0; 95 percent confidence interval, 3.4 to 4.5). The estimated median incubation time from mononucleosis to EBV-positive Hodgkin's lymphoma was 4.1 years (95 percent confidence interval, 1.8 to 8.3). CONCLUSIONS: A causal association between infectious mononucleosis-related EBV infection and the EBV-positive subgroup of Hodgkin's lymphomas is likely in young adults. Udgivelsesdato: 2003-Oct-2

U2 - 10.1056/NEJMoa023141

DO - 10.1056/NEJMoa023141

M3 - Journal article

C2 - 14523140

SN - 0028-4793

VL - 349

SP - 1324

EP - 1332

JO - New England Journal of Medicine

JF - New England Journal of Medicine

IS - 14

ER -