In a study published today in naturopathyResearchers from the University of Oxford and Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam, Tanzania, have shown that a minimally invasive “liquid biopsy” test can rapidly and accurately diagnose Burkitt lymphoma in sub-Saharan Africa, where delay in conventional testing often proves fatal.
Despite its aggressive nature, Burkitt lymphoma is often cured with early treatment, with survival rates exceeding 90%. Treatment is widely available and free of charge in most sub-Saharan countries, although current clinical trials require specialist expertise and laboratory equipment that is often unavailable in resource-limited settings. Due to this, most children are either not diagnosed or diagnosed very late. In much of the region, survival rates may fall below 50%.
“There is an urgent need for new diagnostic methods that are practical and effective in low-resource settings where Burkitt lymphoma is most common”, said Anna Schuh, professor of molecular diagnostics at the University of Oxford and lead researcher on the study. “It is a highly treatable cancer, yet too many children and young adults are not diagnosed in time. As a minimally invasive and accurate approach, liquid biopsy tests have huge potential to transform diagnosis and significantly improve outcomes in sub-Saharan Africa.”
Liquid biopsy detects small amounts of DNA left by cancer cells in the blood. Using a simple blood sample, scientists can identify the specific genetic changes that characterize Burkitt lymphoma and distinguish them from the DNA of healthy cells or other tumor types.
Professor Anna Schuh and her team at Oxford, working together with researchers from MUHAS in Tanzania, the Central Public Health Laboratory in Kampala, Uganda, and 4 study sites in these countries, have developed a minimally invasive liquid biopsy test to rapidly and accurately detect Burkitt lymphoma. This is the first indication that liquid biopsy could play a larger role in diagnosing other cancers in sub-Saharan Africa.
The international research team evaluated the liquid biopsy test in a large group of children and young adults who presented clinical symptoms of lymphoma at four hospitals in Uganda and Tanzania. Its performance was compared to a tissue biopsy-based approach that used diagnostic tests accessible in limited-resource settings.
High accuracy and fast results
The blood test demonstrated a strong ability to distinguish Burkitt lymphoma from other conditions, achieving an overall accuracy of 98%. Of the 81 patients with a confirmed tissue-based diagnosis of Burkitt lymphoma, 86.4% were correctly identified through liquid biopsy.
Importantly, the blood test dramatically reduced the time required to reach a diagnosis. Liquid biopsy diagnosis was an average of 40.3 days faster than tissue biopsy diagnosis.
To understand how the test would perform in real-world clinical practice, the team held weekly multidisciplinary team (MDT) meetings to review cases in real time.
Clara Chamba, head of hematology at MUHAS and study author, said:
“The introduction of liquid biopsy into our multidisciplinary meetings changed how quickly we could start treating our patients. With liquid biopsy, 93% of cases were diagnosed within the first week of sample collection, compared to only 40% when we relied on tissue biopsy alone. For a cancer that grows as fast as Burkitt lymphoma, that time can be life-saving.”
While further work is needed to understand how to scale up the test for clinical use, this study shows that liquid biopsy can serve as a complementary and timely diagnostic tool, especially where access to tissue biopsy is limited or delayed. By increasing diagnostic yield and dramatically reducing the time to diagnosis, this approach could help ensure that children with Burkitt lymphoma begin life-saving treatment sooner.
Professor Bruno Sunguya, Deputy Vice-Chancellor, Research and Consultancy, MUHAS, Tanzania, said:
“The successful implementation and analytical work conducted in Tanzania and Uganda shows that precision medicine research can and should be conducted from within low- and middle-income countries. Beyond lymphoma, this work opens new opportunities to apply genomic and liquid biopsy technologies to strengthen cancer diagnosis across the region and improve outcomes more broadly. This collaboration will help advance innovation, accelerate timely diagnosis, and improve survival for children and adults affected by cancer. “Reaffirms our commitment to improvement.”
