Innovations in Molecular Diagnostic Approaches for HIV-associated Lymphomas.

Univ Of North Carolina Chapel Hill, Chapel Hill NC

Investigators

Abstract

Aggressive B-cell lymphomas are increasingly common but underdiagnosed in people with HIV (PWH) in Malawi. In 2013, we established the Kamuzu Central Hospital (KCH) Lymphoma Study, a prospective observation cohort of pathologically confirmed lymphomas in Malawi that includes uniform diagnosis, standardof-care therapy, and five-year clinical and laboratory follow-up for participants. We have shown that treating lymphoma in PWH is safe and effective, and the Lymphoma Study has become a leading regional resource for clinical and translational research studies of HIV-associated lymphomas. However, current diagnostic strategies are prohibitively expensive which limits the reach of effective lymphoma care, and the pivotal genomic studies from our group are primarily being performed outside of Malawi. Herein, we propose longread nanopore sequencing approaches that require minimal capital investment, and limited lab infrastructure to molecularly diagnose and subclassify common aggressive B-cell lymphomas in PWH. The proposal builds on our work in HIV-associated lymphomas, cutting-edge expertise in long-read nanopore sequencing, and, most critically, and research infrastructure at the UNC-Project Malawi research site. We aim to develop effective, resource-appropriate diagnostic tools and subsequently investigate implementation of nanopore sequencing across a network of sites while performing ongoing clinical, computational, and economic assessments. This project builds capacity to perform advanced molecular characterization of HIV-associated lymphomas in Malawi and leverages ongoing clinical, research, and training programs.