Mentored Clinical Research to Improve Outcomes for Pediatric Mature B Cell Lymphoma in Uganda

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Project Summary/Abstract This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA- 22-036. Outcomes for children with cancer in sub-Saharan Africa (SSA) are unacceptably poor, with fewer than 20% of those diagnosed surviving. By contrast, over 85% of children with cancer in the US survive. The HIV epidemic complicates the landscape of pediatric malignancies in SSA. In partnership with collaborators in SSA, Global HOPE aims to lay the foundation for an international collaborative clinical trial network: Pediatric HIV/AIDS & Infection-Related Malignancies Research Consortium for Sub-Saharan Africa (PARCA). The central problem faced in SSA is the significant burden of HIV-associated malignancies in children and the poor survival of these patients. Global HOPE, a program developed by Baylor College of Medicine (BCM) and Texas Children’s Hospital (TCH), addresses systemic challenges to improve patient outcomes by facilitating the development of a network of pediatric cancer care and research centers across SSA, starting with sites in Uganda, Malawi, Botswana, and Tanzania. Global HOPE focuses on capacity-building and has partnered with the internationally recognized Makerere University College of Health Sciences (MakCHS) in Uganda to create a first-of-its-kind collaborative pediatric hematology-oncology (PHO) training hub. In 2016, Makerere College of Health Sciences (MakCHS) and Global HOPE implemented the first accredited PHO physician postgraduate clinical fellowship training program in SSA. To date, 24 pediatricians from eight African countries have enrolled in this two-year PHO fellowship training Program. Fourteen graduates from the program are currently leading PHO care teams at 7 centers in 4 countries in SSA. In this application, we propose to take advantage of PARCA to support clinical research training of Dr. Anne Akullo, a recent Ugandan graduate of the MakCHS PHO fellowship program, with a mentorship team including Dr. Ruth Namazzi (Lecturer, MakCHS, and Director of the Pediatric Hematology- Oncology Fellowship Program at Makerere University, Kampala, Uganda) and clinical research experts from Houston and Uganda. The overall goal of the parent U54 is to establish a standardized multi-site strategy to deliver safe and effective disease-specific and risk-stratified care to children with mature B cell non-Hodgkin lymphoma (MB-NHL) in SSA. Dr. Akullo’s training will include personalized curriculum and mentored research experience focusing on clinical research goals of Project #3 of the PARCA U54 in Uganda: To investigate clinical and biological characteristics associated with clinical outcomes of children with MB-NHL treated on standardized PARCA treatment regimens.