General Aspects of Lymphoid Malignancies Chronic Lymphoid LeukemiaAcute Lymphoid Leukemia EpidemiologyOlder adults; men>women; Whites>blacks Children and young adults; among higher socioeconomic groups Etiology/ Predisposition Unknown EBV (L3/Burkitt’s) Trisomy 21, high energy radiation; industrial/agricultural chemicals exposure; smoking Fauci, et al., Harrison’s Principles of Internal Medicine, 17 th ed. US:Mcgraw Hill, p. 687

General Aspects of Lymphoid Malignancies Hodgkin’s LymphomaNon-Hodgkin’s Lymphoma EpidemiologyBimodal age distribution (20’s & 80s); males>females; whites>blacks Elderly; men>women Etiology/ Predisposition HIV EBV Primary & secondary immunodeficiency states; HIV; Organ transplant patients; inherited immune deficiency; Sicca syndrome; Rheumatoid arthritis Fauci, et al., Harrison’s Principles of Internal Medicine, 17 th ed. US:Mcgraw Hill, p. 687

Non-Hodgkin’s Lymphoma Incidence and patterns of expression of subtypes differ geographically – Asia – T cell lymphoma – Western countries – B cell (follicular) lymphoma – Southern Asia & Latin America – Angiocentric nasal T/NK lymphoma – Southern Japan & Carribean – Adult T cell Lymphoma (HTLV – 1) Fauci, et al., Harrison’s Principles of Internal Medicine, 17 th ed. US:Mcgraw Hill, p. 688

Non-Hodgkin’s Lymphoma Environmental Factors: – Infectious agents – Chemical exposures – Medical treatments Fauci, et al., Harrison’s Principles of Internal Medicine, 17 th ed. US:Mcgraw Hill, p. 688

Non-Hodgkin’s Lymphoma Infectious agents associated with the development of Lymphoid Malignancies Infectious agentLymphoid malignancy Epstein-Barr virus Burkitt’s lymphoma Primary CNS diffuse large B cell lymphoma Extranodal T cell/NK lymphoma HTLV-1 Adult T cell leukemia/lymphoma HIV Diffuse large B cell lymphoma Burkitt’s lymphoma Hepatitis C virus Lymphoplasmacytic lymphoma Helicobacter pylori Gastric MALT lymphoma Human herpesvirus 8 Primary effusion lymphoma Multicentric Castleman’s disease Fauci, et al., Harrison’s Principles of Internal Medicine, 17 th ed. US:Mcgraw Hill, p. 688

Non-Hodgkin’s Lymphoma Diseases or exposures associated with increased risk of development of malignant lymphoma Inherited immunodeficiency states Klinefelter’s syndrome Chediak-Higashi syndrome Ataxia telangiectasia syndrome Wiscott-Aldrich syndrome Common variable immunodeficiency states Acquired immunodeficiency states Iatrogenic immunosuppression HIV-1 infection Acquired hypogammaglobulinemia Autoimmune diseaseSjogren’s syndrome Celiac sprue Rheumatoid arthritis and SLE Chemical and drug exposuresPhenytoin Dioxin, phenoxyherbicides Radiation Prior chemotherapy and radiation therapy Fauci, et al., Harrison’s Principles of Internal Medicine, 17 th ed. US:Mcgraw Hill, p. 688