An initiative to improve the diagnosis of childhood viral lymphomas in Sub-Saharan Africa using liquid biopsies is beginning this month. Researchers hope that the effort will be able to validate liquid biopsy (LB) diagnostic methods for childhood lymphomas that are endemic in the region. Research in the LB space has shown that viral DNA in patient blood samples can be used to detect and diagnose virus-associated cancers, spurring the initiative.

So far, research in the space has been focused on diagnostic tests for tumours that occur in the head and neck, including tumours associated with the human papillomavirus (HPV) or Epstein-Barr virus (EBV). However, for this new effort, the target also involves EBV-associated tumours but the cancer is in the lymphatic system.

EBV lymphomas are curable with chemotherapy, but a prompt diagnosis is not happening in the effected regions. Anna Schuh, Director of molecular diagnostics at the University of Oxford states that now the mortality of those affected in most areas in sub-Saharan Africa is near 100%. With treatment being free for many countries in the area, highlighting the importance of rapid diagnostics.

Currently, diagnosis in Sub-Saharan Africa is done via a traditional biopsy of the tumours. Schuh states that “only 29% of hospitals with paediatric facilities have a surgeon that can do a biopsy, and there are not enough pathologists that can perform the diagnostics robustly”.

The method behind the EBV project is based on a mixture of tumour and viral sequencing. The program will stretch over four years, with the ultimate goal being to nail down the most cost-effective method for diagnosis: either by liquid biopsy or traditional pathology screening.

Illumina has donated two iSeq instruments for the project, which are already installed in the Muhumbili University of Health and Allied sciences in Tanzania. With not a single sample set to leave the country, the project aims to educate people to create capacity for the diagnostic tests. In addition, the program is using part of the budget to procure rituximab, the monoclonal antibody therapy that is being used in combination with chemotherapy in the West. This ensures that the children taking part gets the same treatment that they would in developed countries.