What is unique about EMBLEM?
- Conducted in rural areas where BL incidence is highest;
- Involved multiple, networked sites in three countries;
- Designed to obtain samples with permission for GWAS and exome studies;
- Population-based cases and controls
The primary goals of EMBLEM are to investigate:
- risk factors of BL in endemic populations in East Africa;
- EBV and Pf immuno-profiles and other biomarkers associated with BL;
- molecular characteristics of BL tumor genomes, B-cell receptor, and EBV variants; and
- germline risk factors of BL using genome-wide association studies (GWAS) and exome sequencing
- the association between BL and human leukocyte antigen (HLA) class I and II loci.
Burkitt lymphoma (BL) is a life-threatening malignancy of germinal center B cells first discovered in 1958 by Denis Burkitt an endemic childhood cancer (eBL) in sub-Saharan Africa, but it occurs sporadically (sBL) in most populations. Infections by Epstein-Barr virus (EBV) and Plasmodium falciparum (Pf) malaria are linked to the geographical distribution of eBL cases. However, both infections affect significantly more people than those who develop eBL suggesting the influence of other poorly defined risk-factors. The co-factors may include genetic variants of EBV or Pf, other infections, host genetic predisposition, trace elements or dietary factors, such as systemic magnesium or selenium, and environmental factors, such including euphorbia plants. Identification of co-factors would provide tools for the prevention and/or treatment of BL, lack of datasets with subject-associated specimens hampers in-depth integrative studies of BL.
Achievements at a glance
- 4 study status and scientific update meetings in the region to build local capacity for research and report back to local communities about BL.
- 2 BL Scientifics Sessions and 2 BL Workshop at the African Organization for Research and Training in Cancer (AORTIC).
Publications related to study implementation
- Accuracy of Burkitt lymphoma diagnosis in constrained pathology settings: importance to epidemiology.
- A case-control study of Burkitt lymphoma in East Africa: are local health facilities an appropriate source of representative controls?
- African Burkitt's lymphoma: could collaboration with HIV-1 and malaria programmes reduce the high mortality rate?
- Incidence and geographic distribution of endemic Burkitt lymphoma in northern Uganda revisited.
- Building capacity for sustainable research programmes for cancer in Africa.