Non-Hodgkin’s Lymphoma Risk Factors


Risk factors are the inherited or acquired factors that increase the chance of developing cancer in a person. Several epidemiological studies have suggested a number of genetic and environmental factors that may predispose to Non-Hodgkin’s Lymphoma. A knowledge about them helps us to make necessary lifestyle choices.

Non-Hodgkin’s Lymphoma risk factors:

  • Age: Most NHL types are common among old-age individuals with an exception of a few types more common among youngsters.

  • Gender: Most NHL types are common in males compared to females with an exception of a few types more common in females.

  • Race and ethnicity: NHLs are most commonly reported in Caucasians compared to African Americans and Asian Americans, in the US.

  • Exposure to Radiation: Individuals with a history of exposure to radiation, for example, survivors of atomic bomb explosions and nuclear reactor accidents remain at high risk of developing NHLs.

  • Exposure to certain chemicals: Chronic exposure to certain chemicals like benzene, arsenic, chlorophenols, lead, vinyl chloride, asbestos, insecticides, and herbicides have been reported to elevate the risk of developing certain types of NHL.

  • Geographical location: Some NHL types are restricted to certain geographical locations, for example, endemic Burkitt lymphoma (BL) that is usually observed in equatorial African children and Adult T-cell leukemia/lymphoma (ATLL) that is generally observed in southern Japan, the Caribbean basin, western Africa, the Southeastern United States and northeast Iran.

  • Infection: Risk of developing certain types of NHL is higher in individuals who have a history of infection with associated viruses or other pathogens. Following are some examples:
    • Epstein-Barr virus (EBV) infection is generally associated with the incidence of Burkitt lymphoma (BL) in African children, Angioimmunoblastic T-cell lymphoma (AITL), Extranodal NK-/T-cell lymphoma (ENKL), and post-transplantation lymphoproliferative disorder (PTLD).

      In conjunction with HIV, EBV infection may lead to the development of Plasmablastic lymphoma (PBL) and primary effusion lymphoma (PEL).
    • Human T-cell lymphotropic virus (HTLV-1) infection has been linked with the development of Adult T-cell leukemia/lymphoma (ATLL) commonly observed in Japan and Caribbean region.
    • Human herpesvirus 8 (HHV-8) infection increases the risk of PEL.
    • HIV infection is usually associated with the development of primary CNS lymphoma (PCNSL), BL, and diffuse large B-cell lymphoma (DLBCL).
    • Hepatitis C virus is usually associated with Lymphoplasmacytic lymphoma (LPL)/ Waldenström’s macroglobulinemia (WM) and splenic marginal zone lymphoma (MZL).
    • Helicobacter pylori infection has been reported to cause mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach.
    • Chlamydophila psittaci infection may result into MALT lymphoma in the tissues around the eye.
    • Campylobacter jejuni infection may cause MALT lymphoma of the small intestine.
    • Borrelia burgdorferi infection has been reported to be associated with the development of extranodal MZLs.
  • Weakend immune system: Individuals with a weak immune system that may be due to HIV infection, auto-immune disease, or immunosuppressants in patients who have undergone an organ transplant are considered at higher risk of developing certain types of NHL, for example, PTLD, AIDS-Related NHLs, and DLBCL.

    Certain inherited immunodeficiency syndromes such as Wiskott-Aldrich syndrome, Chédiak-Higashi syndrome, X-linked lymphoproliferative syndrome, ataxia telangiectasia, and common variable immunodeficiency syndrome have been linked to increased incidence of aggressive lymphomas.

  • Family History: Individual with a history of NHL, HL, or chronic lymphocytic leukemia (CLL) in close relatives are considered to be at increased risk of developing NHL. The risk is particularly very high in individuals who have an identical twin who got the disease at a younger age.

  • Breast implants: Patients who had have breast implants with the textured surface are considered at an increased risk of developing breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).

Body weight and diet have also been reported to play a role in the development of a few types of NHL. Obese people and individuals who consume fat-rich diet are generally at higher risk of developing some types of NHL.

In the next section, you will read about the symptoms of Non-Hodgkin’s Lymphoma.

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