{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:04:04Z","timestamp":1790665444584,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pediatric Hodgkin lymphoma in sub\u2010Saharan Africa is frequently associated with Epstein\u2013Barr virus (EBV), providing a unique opportunity to investigate the molecular characteristics and clinical significance of EBV\u2010associated disease in an understudied population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedures<\/jats:title>\n                    <jats:p>We conducted an observational cohort study of 50 children and young adults with newly diagnosed classical Hodgkin lymphoma (cHL) in Tanzania and Uganda. Plasma cell\u2010free DNA collected at diagnosis was analyzed for circulating tumor DNA (ctDNA), EBV\u2010derived biomarkers, and somatic mutations. Associations between clinical, molecular, and survival outcomes were assessed using correlation analyses and Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age was 12\u00a0years and 62% of participants were male. Most patients presented with advanced\u2010stage disease. ctDNA was detected in 60% of patients with a low mutational burden, while EBV DNA was detected in 92% of cases. Male patients exhibited higher EBV\u2010derived markers and fewer\n                      <jats:italic>TNFAIP3<\/jats:italic>\n                      and\n                      <jats:italic>B2M<\/jats:italic>\n                      mutations. At a median follow\u2010up of 17.2\u00a0months, overall survival was 84% and event\u2010free survival was 50%; male sex and elevated lactate dehydrogenase independently predicted inferior event\u2010free survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings reveal a low mutational burden and sex\u2010associated molecular and clinical differences in EBV\u2010positive cHL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70710","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:53:03Z","timestamp":1790664783000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Analysis of Epstein\u2013Barr Virus and Tumor\u2010Derived Circulating Plasma DNA in Children and Young Adults With Classical Hodgkin Lymphoma in East Africa"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5154-7872","authenticated-orcid":false,"given":"Clara","family":"Chamba","sequence":"first","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heavenlight","family":"Christopher","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5502-9156","authenticated-orcid":false,"given":"Emmanuel","family":"Josephat","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius","family":"Sseruyange","sequence":"additional","affiliation":[{"name":"Central Public Health Laboratories  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisen","family":"Ayitewala","sequence":"additional","affiliation":[{"name":"Central Public Health Laboratories  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"Dreau","sequence":"additional","affiliation":[{"name":"University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8787-9147","authenticated-orcid":false,"given":"Adam","family":"Burns","sequence":"additional","affiliation":[{"name":"University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Otim","sequence":"additional","affiliation":[{"name":"St. Mary's Hospital, Lacor  Gulu Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6489-0374","authenticated-orcid":false,"given":"Priscus","family":"Mapendo","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre  Moshi Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Mnango","sequence":"additional","affiliation":[{"name":"Muhimbili National Hospital  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7226-0168","authenticated-orcid":false,"given":"Alex","family":"Mremi","sequence":"additional","affiliation":[{"name":"KCMC University  Moshi Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7281-499X","authenticated-orcid":false,"given":"Edrick","family":"Elias","sequence":"additional","affiliation":[{"name":"Catholic University of Health and Allied Sciences  Mwanza Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Achola","sequence":"additional","affiliation":[{"name":"Central Public Health Laboratories  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Mawalla","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5008-3786","authenticated-orcid":false,"given":"Lulu","family":"Chirande","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Kamanga","sequence":"additional","affiliation":[{"name":"Bugando Medical Centre  Mwanza Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6118-542X","authenticated-orcid":false,"given":"Ismail","family":"Legason","sequence":"additional","affiliation":[{"name":"Muni University  Arua Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salama","family":"Mahawi","sequence":"additional","affiliation":[{"name":"Muhimbili National Hospital  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9068-0991","authenticated-orcid":false,"given":"Godlove","family":"Sandi","sequence":"additional","affiliation":[{"name":"Muhimbili National Hospital  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1295-7921","authenticated-orcid":false,"given":"Heronima J.","family":"Kashaigili","sequence":"additional","affiliation":[{"name":"Catholic University of Health and Allied Sciences  Mwanza Tanzania"},{"name":"Bugando Medical Centre  Mwanza Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul Shadrack","family":"Ntemi","sequence":"additional","affiliation":[{"name":"Bugando Medical Centre  Mwanza Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erick","family":"Magorosa","sequence":"additional","affiliation":[{"name":"Muhimbili National Hospital  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mbwambo","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre  Moshi Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Ogwang","sequence":"additional","affiliation":[{"name":"St. Mary's Hospital, Lacor  Gulu Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Vavoulis","sequence":"additional","affiliation":[{"name":"University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3707-9985","authenticated-orcid":false,"given":"Emmanuel","family":"Balandya","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Cutts","sequence":"additional","affiliation":[{"name":"University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5938-5628","authenticated-orcid":false,"given":"Eli","family":"Mkwizu","sequence":"additional","affiliation":[{"name":"KCMC University  Moshi Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Schuh","sequence":"additional","affiliation":[{"name":"Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"},{"name":"University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13045\u2010022\u201001281\u20109"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2013.07.016"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V81.2.462.462"},{"issue":"2","key":"e_1_2_12_5_1","first-page":"116","article-title":"Hodgkin Lymphoma: A Review and Update on Recent Progress","volume":"68","author":"Shanbhag S.","year":"2018","journal-title":"CA: A Cancer Journal for Clinicians"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102141.2004.04902.x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2022009398"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2333794X231223266"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmg.2022.104672"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102017\u201011\u2010814913"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1158\/2767\u20109764.CRC\u201023\u20100140"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019001012"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2024027355"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hem3.70357"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010021\u201001204\u20106"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010023\u201006903\u2010x"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hon.2704"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(15)70106\u20103"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102017\u201011\u2010812073"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.237719"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1200\/GO.24.00210"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010026\u201004291\u2010z"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1101\/861054"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/nmeth0410\u2010248"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102141.2011.08772.x"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20090528"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199811193392104"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.33.3369"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010019\u20101272\u20106"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1804184115"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/1545-5017.70710","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/1545-5017.70710","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/1545-5017.70710","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:53:04Z","timestamp":1790664784000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/1545-5017.70710"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":29,"alternative-id":["10.1002\/1545-5017.70710"],"URL":"https:\/\/doi.org\/10.1002\/1545-5017.70710","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]},"assertion":[{"value":"2026-06-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70710"}}