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CA: A Cancer Journal for Clinicians, Vol 31, 359-364, Copyright © 1981 by American Cancer Society

Hodgkin's Disease and Infectious Mononucleosis: Is There a Causal Association?

¹ Associate Attending Physician, Hematology/Lymphoma Service, at Memorial Sloan-Kettering Cancer Center, New York, New York.

There is a very strong desire to discover an oncogenic virus in humans. The Epstein-Barr herpes virus is certainly the most provocative agent stimulating such research investigation over the past decade. Failure to establish a simple and clear relationship between the Epstein-Barr herpes virus and Hodgkin's disease has led to additional research that has attempted to link the potential relationship with the possible genetic differences among patients with Hodgkin's disease. Hodgkin's disease has been characterized by ethnic variations in incidence, as well as a high frequency of certain HL-A antigens. In several ethnic groups, Hodgkin's disease was found to correlate significantly with the mean gene frequency of HL-Al and HL-A8. Vianna. therefore, speculated that, "if Hodgkin's disease does have an infectious component with racial distribution of HL-A antigens controlling the degree of susceptibility and transmission, this could have a profound influence on the results of epidemiological, biological, and immunological studies that attempt to determine the nature of this disorder."

One can therefore conclude that, to date, there is still no clear agreement that there is any absolute relationship between the EB virus, infectious mononucleosis, and Hodgkin's disease. Because of the frequency of incidence of infectious mononucleosis and the rarity of Hodgkin's disease, it is important to maintain an emotionally balanced point of view, to avoid causing unnecessary anxiety among those who may develop infectious mononucleosis. On the basis of current data, it is incorrect to imply that those who develop infectious mononucleosis may be significantly more susceptible to Hodgkin's disease.

In the absence of firm data, it is better to conclude, for the time being, that the true association between infectious mononucleosis, Hodgkin's disease, and the EB virus is at best worthy of continuing scientific investigation by a variety of disciplines.