History of Infection and Antibiotic Use and Risk of Non-Hodgkin's Lymphoma

Ikuko Kato, Ph.D., Karen L. Koenig, Ph.D., and Roy E. Shore, Ph.D.
New York University School of Medicine
P30ES00260

Background: A growing body of research suggests that a variety of infectious agents may play roles in the development of several human cancers. Malignant lymphoma is the first human tumor for which an association with infectious agents was established. Since the discovery of the involvement of Epstein Barr virus in Burkitt's lymphoma, multiple viruses and bacteria, including HIV, hepatitis C virus and helicobacter pylori, have been linked with several types of malignant lymphoma. Although some viruses are known to stimulate lymphocytes directly, leading to monoclonal growth, other mechanisms have been proposed for an association of infectious agents with lymphoma. These observations suggest that infections that cause chronic inflammatory conditions potentially increase the risk of lymphoma.

To investigate the possibility that certain infections and antibiotic use are associated with risk of non-Hodgkin's lymphoma, these investigators conducted a population-based case-control study among women in upstate New York.

Advance: The results of the study showed a progressive increase in the risk of non-Hodgkin's lymphoma with increasing frequency and duration of systemic antibiotic use over the 2-20 year period prior to the beginning of the study. For the highest exposure group, consisting of more than 35 episodes or more than 1 year of use, the risk was 2.5 times higher than in controls. These associations were primarily due to antibiotic use for respiratory infections and dental conditions. Analyses by class of antibiotic use did not suggest a general cytotoxic effect of antibiotics was responsible for the increased risks.

Implication: The results of this study are generally consistent with the hypothesis that chronic infection and/or inflammation may predispose individuals to the development of non-Hodgkin's lymphoma. A direct role of antibiotic use in the development of non-Hodgkin's lymphoma could not be ruled out. The authors conclude that if the non-Hodgkin's lymphoma-antibiotic association is due to frequent/prolonged infections, the proper use of appropriate antibiotics might actually contribute to reducing the risk of the disease.

Citation: Kato I, Koenig KL, Baptiste MS, Lillquist PP, Frizzera G, Burke JS, Watanabe H, Shore RE. History of antibiotic use and risk of non-Hodgkin's lymphoma (NHL). Int J Cancer. 2003 Oct 20;107(1):99-105.