The EMBLEM study is being conducted in rural areas of Northern Uganda, Northern Tanzania, and Western Kenya, where malaria endemicity is high all year-round. The study will:
- Enroll 1,500 histologically confirmed cases.
- Enroll two population-based controls (for a total of 3,000) per case, frequency matched on age and gender.
- Collect information about malaria exposures using questionnaires and blood and saliva samples from both cases and controls.
- Collect frozen and formalin fixed tumor tissues from cases.
The study is designed to investigate the role of malaria, malaria immunology, and genetic factors in Burkitt’s lymphoma in children living in malaria-endemic areas. The cumulative impact of malaria will be evaluated by testing for carriage of malaria-resistant genes (e.g., sickle trait). The frequency of malaria-resistant genes in cases and controls will be compared. Statistical methods will be used to test the hypothesis that malaria-resistant genes are associated with decreased risk for Burkitt’s lymphoma. This approach is appropriate since both cases and controls live in the same area and are likely to experience similar risks for environmental malaria.
In addition, the study will investigate the role of EBV variants in Burkitt’s lymphoma. EBV variants will be characterized using novel high throughput EBV genotyping assays being developed in collaboration with the NCI Advanced Technology Center.
Burkitt’s lymphoma is the most common childhood tumor in Africa and malaria, although both treatable and preventable, is the most widespread childhood exposure. Understanding the role of malaria, EBV, and genetics in Burkitt’s lymphoma will answer important scientific questions about the cause and biology of the disease. This information may be important for surveillance, diagnosis, clinical care and prevention.