INFECTIONS AND FOLLICULAR LYMPHOMA: IS THERE A LINK?

Several infectious agents appear to provide a proliferative signal -- “antigen-drive” – that  could be implicated in the pathogenesis of various type of Non-Hodgkin Lymphoma (NHL). A classical model of infection-driven lymphoprolipherative disorder is Helicobacter pylori-induced gastric MALT lymphoma, where antibiotic therapy allows eradication of both the infectious agent and the clonal B-cell expansion;  following the footsteps of these example, several retrospective studies have found a correlation with other pathogens and B-cell Lymphomas, adding new important informations about pathogenesis and laying the groundwork for chemotherapy-free treatments.

Although no clear association with infectious agents has yet been identified for Follicular Lymphoma (FL), a growing number of biological and clinical observations suggests that interaction with physiological and pathological microbial populations might play a role also in this subtype of lymphoma: in the last years epidemiological studies investigating the association of known risk factors and FL found a potential correlation with viral or bacterial infections; moreover recent findings about the stimulation of FL clones support the importance of microbial exposure to lymphomagenesis and disease progression.

In the following review we make an attempt to find tangible evidences in favor of a role of either physiological and pathological exogenous microbial species in the pathogenesis of FL, and try to integrate the findings coming from epidemiological, biological and interventional studies to define future  novel treatment and prevention strategies for FL.