Burkitt’s lymphoma(BL)is among the most common pediatric cancers in Sub-Saharan African children,accounting for 30-50%of malignancies in Sub-Saharan African children,with a strong etiological link with Epstein-Barr v...Burkitt’s lymphoma(BL)is among the most common pediatric cancers in Sub-Saharan African children,accounting for 30-50%of malignancies in Sub-Saharan African children,with a strong etiological link with Epstein-Barr virus(EBV)infection.The disease is especially aggressive in nature,with more than 70%mortality when diagnosed at advanced stages which is frequent and resulting from poor healthcare infrastructure and limited access to diagnostic facilities.Liquid biopsy approaches,which detect tumor-derived components in bodily fluids,offer promising potential for early,minimally invasive detection of EBV-positive BL.Emerging evidence suggests liquid biopsy methods can reduce diagnostic delays from weeks to≤48 h without compromising>85%concordance with tissue biopsy,demonstrated in Malawi and Kenyan pilot trials(2021-2023).According to the WHO-AFRO report(2023),due to administrative and cost burdens,only 15%of regional clinics are offering liquid biopsy testing as liquid biopsy test costs approximately 120/test as compared to histopathology,which costs$35.This review critically evaluates the technical and implementation challenges associated with developing liquid biopsy assays specifically tailored for BL detection in resource-limited settings across Sub-Saharan Africa.We discuss recent technological advances in circulating tumor DNA(ctDNA)analysis,EBV biomarker detection as technical validations of ctDNA and EBV marker assays have 90-95%sensitivity in early studies,and point-of-care diagnostics,alongside the logistical,economic,and sociocultural barriers to their effective implementation.Additionally,we propose strategic frameworks for overcoming these challenges through collaborative international partnerships,capacity building initiatives,and context-appropriate technology adaptation.Through all these cross-sector partnerships and approaches could transform BL outcomes by enabling stage-shift to 80%early-stage diagnoses,reducing mortality rates by 50%,potentially doubling survival rates in high-burden regions.展开更多
文摘Burkitt’s lymphoma(BL)is among the most common pediatric cancers in Sub-Saharan African children,accounting for 30-50%of malignancies in Sub-Saharan African children,with a strong etiological link with Epstein-Barr virus(EBV)infection.The disease is especially aggressive in nature,with more than 70%mortality when diagnosed at advanced stages which is frequent and resulting from poor healthcare infrastructure and limited access to diagnostic facilities.Liquid biopsy approaches,which detect tumor-derived components in bodily fluids,offer promising potential for early,minimally invasive detection of EBV-positive BL.Emerging evidence suggests liquid biopsy methods can reduce diagnostic delays from weeks to≤48 h without compromising>85%concordance with tissue biopsy,demonstrated in Malawi and Kenyan pilot trials(2021-2023).According to the WHO-AFRO report(2023),due to administrative and cost burdens,only 15%of regional clinics are offering liquid biopsy testing as liquid biopsy test costs approximately 120/test as compared to histopathology,which costs$35.This review critically evaluates the technical and implementation challenges associated with developing liquid biopsy assays specifically tailored for BL detection in resource-limited settings across Sub-Saharan Africa.We discuss recent technological advances in circulating tumor DNA(ctDNA)analysis,EBV biomarker detection as technical validations of ctDNA and EBV marker assays have 90-95%sensitivity in early studies,and point-of-care diagnostics,alongside the logistical,economic,and sociocultural barriers to their effective implementation.Additionally,we propose strategic frameworks for overcoming these challenges through collaborative international partnerships,capacity building initiatives,and context-appropriate technology adaptation.Through all these cross-sector partnerships and approaches could transform BL outcomes by enabling stage-shift to 80%early-stage diagnoses,reducing mortality rates by 50%,potentially doubling survival rates in high-burden regions.
