A new study from the University of Nevada and University of California, San Francisco found newborns exposed to CMV, a very common virus in the Herpes family, increases their risk of ALL, acute lymphoblastic leukemia.
The Herpes Virus family, or Herpesviridae, contain a group of viruses of which we are well familiar. These include Herpes I and II causing oral and genital lesions; Varicella-Zoster, responsible for chicken pox and shingles; Epstein-Barr, associated with mononucleosis; and CMV, cytomegalovirus, which most commonly does not produce symptoms but when it does it could range from a mild fever, viral illness, to serious complications such as seizures. The CDC states 50% of the adult population by age 40 are infected with CMV and some sources cite close to 80%. Again, many of theses cases fail to cause symptoms or any illness.
But any of the above viruses, however, can cause serious complications in neonates. We’ve known for some time that CMV could cause deadly issues in infants such as liver failure, pneumonia, low birth weight, microcephaly and seizures, and we’ve also suspected a cancer link. CMV should not cause cancer but its been linked to many. Now this particular study evaluated children with Acute Lymphoblastic Leukemia (ALL) and found CMV in the bone marrow of all children tested. Then they evaluated two groups of children, one of which developed ALL, and again confirmed the link.
Acute Lymphoblastic (Lymphocytic) Leukemia occurs when an immature white blood cell, such as T or B lymphocytes, created in the bone marrow to combat infection, abnormally accumulates and becomes cancerous. This is different from AML (Acute Myelogenous Leukemia) in which a myeloid cell (macrophage/monocyte/platelet and giving rise to red blood cells) becomes cancerous. AML is the most common type of leukemia in adults, whereas ALL is the most common type of leukemia in young children even though both can be found in adults and children. The overcrowding of these blood cells prevent new blood cells from being formed properly and can cause symptoms of frequent infections, shortness of breath, fatigue, pain, easy bleeding and bruising and swollen lymph nodes.
ALL, however, can be successfully treated, with St. Jude citing 90% of children can be cured. 98% can go into remission within weeks of starting treatment and after 10 years of remission they are considered cured. Treatments include chemotherapy, stem cell transplants and bone marrow transplants, and radiation therapy.
If a pregnant mom becomes newly infected with CMV a high-risk obstetrician will oversee and manage the pregnancy and the fetus with ultrasound and amniocentesis. A person with a previous infection to CMV (since its a very common virus) appears to be unlikely to reactivate and infect their fetus.
A current CMV infection will have the symptoms of fever, swollen glands, fatigue and sore throat, so pregnant women with any of these symptoms should discuss with her medical provider. Not all women pass CMV to their fetus’ nor all fetuses infected show organ damage. However, congenital CMV infection can be serious and this recent study highlights its potential for cancer.
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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician