This is because a virus called Epstein-Barr virus (EBV), malaria and HIV all contribute to causing these specific types of lymphomas.
Their treatment is widely available and free-of-charge in most sub-Saharan countries. However, currently, most children either remain undiagnosed, present late to hospital, or are diagnosed late while in hospital. One of the main reasons for this is the lack of reliable hospital-based diagnostics services with enough surgeons and pathologists to establish the precise diagnosis fast enough.
The first takes complete pictures of tissue biopsies with a small and affordable mobile camera that can be attached to any microscope. These pictures can then be sent anywhere in the world for interpretation. It means that fewer pathologists would be required for diagnosis, which would be hugely beneficial, especially in remote places.
The second technology uses a simple blood test to make the diagnosis of lymphoma. This technology, also known as DNA-based diagnostics (because it relies on tracing DNA from tumours and viruses that cause the cancer), has been used already in other EBV-related cancers and in lymphomas in other areas to detect the disease much earlier than with conventional methods. We have now developed this technology specifically for the EBV-related lymphomas in sub-Saharan Africa. It means that children might not need an invasive biopsy anymore to make the diagnosis.
We will recruit 280 children and young adults to clinically validate our technologies, and to test whether they speed up the diagnosis, increase the number of diagnosed children (especially among those too unwell to undergo invasive biopsy testing), and if it improves survival. We will also examine whether our approach is cost-effective and affordable for sub-Saharan countries. At the same time as providing a diagnosis, our DNA-based diagnostics will also generate important information about the virus itself, which can help other researchers design future vaccines against EBV.
Our proposal brings together a network of clinicians in Tanzania and Uganda, pathologists and technicians, NGOs, research organisations, and patient and parent groups. We have support from senior government members in both countries. We also have strong links with the Ministry of Health and private and public healthcare insurers. Our plan for long-term sustainability includes the creation of a Social Enterprise of DNA-based diagnostics and the leverage of existing initiatives for public and patient engagement to raise awareness of EBVL and the importance of early diagnosis.
Professor Anna Schuh
MD, PhD, FRCP, FRCPath, Honorary Consultant Haematologist, University of Oxford, UK
Professor Anna Schuh completed academic and clinical haematology training in Oxford in 2006. Since then, she has been a principal investigator for over 30 early and late phase practice-changing clinical trials in chronic lymphocytic leukaemia. Her laboratory research has been with the evaluation of precision diagnostics tools for patients with cancer, in particular whole genome sequencing. In the past three years, her group has focussed on the analysis of liquid biopsies for early cancer diagnosis and monitoring of minimal residual disease. She is the director of an online part-time Precision Cancer Medicine Master's program and has published over 280 peer-reviewed publications. She receives grant funding from NIHR, CRUK, Welcome Trust, Innovate UK and various industry partners. .
Sam M. Mbulaiteye, MBChB, M.Phil., M.Med., of the DCEG Infections and Immunoepidemiology Branch (IIB), presented an NIH Director's Seminar titled "Burkitt Lymphoma: A Model of Polymicrobial Carcinogenesis and Global Oncology", and discussed his ideas for future research collaboration.
CPI is a new, commercially sustainable social enterprise which focuses on curing the curable through precise DNA-based diagnosis that will prevent the needless deaths of thousands of children in Sub-Saharan Africa (SSA).
SEREN is a new, commercially sustainable social enterprise which focuses on curing the curable through precise DNA-based diagnosis that will prevent the needless deaths of thousands of children in Sub-Saharan Africa (SSA).