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Cancer Genetics

Third Generation Lymphoma

08/17/2000

Question:

My husband was diagnosed asymptomatic at age 40 with stage IV Non-Hodgkin's lymphoma. His father was diagnosed shortly thereafter with mantel cell (a NH sub-type, I believe). Now my 7 year old son is undergoing diagnostics for a suspected enlarged lymph on his lower jaw. How cautious should I be that this may be some type of genetic disaster among the male side of his dad`s family?

Answer:

Although much is known about the diagnosis and treatment of Non-Hodgkin`s lymphoma (NHL), not as much is known about its underlying genetic causes. There have been reports of families in which more than one person has developed NHL. Some studies suggest that the risk of developing NHL is higher in the brothers and sisters of people with NHL, but not higher in their children or parents. At this time, however, we do not know how strong this genetic link may be, and we do not know if there are specific genes that can put a person at a higher risk for developing NHL.

Many studies suggest that while there may be a genetic component to lymphomas, non-genetic factors such as hazardous chemical exposures, having a history of certain immunologic conditions, and exposure to specific viruses may play a stronger role. More research is necessary to better understand these genetic and non-genetic factors.

In regard to your family situation, it is difficult to know whether or not the family history places your son at a higher risk for lymphoma. There are only a handful of things that are passed exclusively from males to males in a family; none of them have anything to do with cancer.

In regard to your son`s current medical situation, it may be helpful for his physicians to know about the family history, in case this may help them in their evaluations. There are many things that can cause an enlarged lymph node in the neck in children; most of them are related to infection rather than cancer.

If you or your husband have further questions about the family history, I would suggest speaking with a genetic counselor in your area. They can perform a more formal risk assessment for your family. Also there are several researchers interested in studying families with more than one case of lymphoma, and a genetic counselor can help your family enter such a study if you are interested. They can also discuss the pros and cons of entering a research study.

References: American Cancer Society Textbook of Clinical Oncology, 2nd edition, 1995.

Linet, et al Cancer Research 1992 52(19 Suppl), 5468s-5473s.

Paltiel, et al Cancer 2000 88(10), 2357-66.

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Response by:

Rebecca J Nagy, MS, CGC Rebecca J Nagy, MS, CGC
Formerly, Clinical Instructor of Genetics
School of Medicine
Case Western Reserve University