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Alert Number 172

Mononucleosis and CLL: a Straw Poll

July 8, 2006.

As we point out in our latest article, The Enemy within, very recent research suggests that infectious mononucleosis leaves behind a permanent and important deficit (the authors call it a ‘scar’) on T-cell function. There is also new report from M. D. Anderson that EBV RNA is detected in the bone marrow of a significant percent of CLL patients, but not in “normal” people used as controls. All of this is of vital importance to us since Keating, et al. also suggest EBV RNA in the bone marrow has a very dramatic (negative) effect on 10 year survival chances.

I decided to do a little survey of my own to see if there was a link between prior case of mononucleosis and present diagnosis of CLL. At the end of my article I asked people to write if they (1) had infectious mononucleosis as kids or young adults and (2) if they had more than their share of infections and/or skin cancer issues. Out of the roughly 1,000 people who read my article thus far, I heard back from 15 people who answered yes to both questions. It is reasonable that there are far more of you guys out there who did not chose to write back, or have not gotten around to doing it. Even if we use just the folks that answered, the incidence in the CLL patient population is 1.5%, and is likely to be much higher if everyone had responded.

You would be interested to know, the incidence of infectious mononucleosis in the general public is estimated at 0.045%. That means the incidence of mono in CLL patients is at least 33 times higher, and this is likely to be a gross underestimate.

I don’t know about you, but the results of this straw poll blew me away. I have not been able to find any rigorous study or survey that has looked at prior mononucleosis as a risk factor in developing CLL down the road, so I have no way of judging the validity of our very unscientific straw poll. If any of you are aware of such a study, please let us know.

Hmmm.. I wonder what we can do to get such a poll conducted, with larger sample size and therefore more reliable statistics.

Be well,

Chaya
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