Burkitt lymphoma: a model of polymicrobial carcinogenesis and global oncology

NIH Director's Seminar It has been just over 50 years since the description of Burkitt Lymphoma (BL) as an unusual tumor affecting jaws of African children. Seminal discoveries linked to BL includ Epstein-Barr virus, the first human virus linked to a human cancer, the linkage of BL to Plasmodium falciparum malaria, chromosomal translocations involving c-myc and immunoglobulin promoter elements, and demonstration of rapid and curative response to chemotherapy. Dubbed the Rosetta stone of cancer, BL became a complex model for carcinogenesis involving poly-microbes, immunity and host-genetics. Fifty years later, many fundamental questions remain unanswered. Why BL occurs in a small fraction of people chronically exposed to malaria and/or EBV, the risk conveyed by infections singly or jointly, the specific malaria or EBV proteins involved, and whether EBV or malaria have high-risk variants for BL and the pathogen-host interactions involved in BL. In addition, we do not know how to prevent or adequately treat BL. The lecture will dissect the epidemiology of BL, particularly in Africa. It will explore the inherent difficulties quantifying the association of malaria, EBV, and other exposures in human populations in an effort to summarize the strength and weaknesses of the evidence linking EBV and malaria to BL. Borrowing from malaria diagnostic and vaccine studies, the lecture will explore new approaches to quantify risks of association with specific pathogen proteins and insight...
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