This is an application for a Fogarty International Center K01 International Research Scientist Development Award for Dr. Satish Gopal, an infectious disease physician and medical oncologist at the University of North Carolina at Chapel Hill. Dr. Gopal is establishing himself as a young investigator in the areas of HIV-associated lymphoma and lymphoma treatment in resource-limited settings. This K01 award will provide Dr. Gopal with the support necessary to accomplish the following goals: (1) to become an expert in clinical trial conduct in resource-limited settings;(2) to develop skills in multidisciplinary, long-distance collaboration;(3) to gain additional experience in advanced study design and biostatistical methods;and (4) to learn fundamentals of health-related quality of life research. To achieve these goals, Dr. Gopal has assembled a mentoring team comprised of a US primary mentor, Dr. Thomas Shea, Interim Chief of the Division of Hematology and Oncology, an international leader in collaborative clinical trials in hematologic malignancies, and a Malawi primary mentor, Dr. Mina Hosseinipour, Clinical Director of UNC Project-Malawi and an expert in clinical trials in sub-Saharan Africa, as well as three co-mentors;Drs. Blossom Damania and Dirk Dittmer, experts in pathogenic mechanisms of viral oncogenesis with particular interest in HIV malignancies;and Dr. William Miller, an expert in analytic methods and mentoring young investigators toward research independence. Lymphoma is one of the most common cancers in sub-Saharan Africa with rapidly increasing incidence. Dr. Gopal's research will focus on accurate histopathologic diagnosis among patients with suspected lymphoma in Malawi (Aim 1), systematic collection of clinical and laboratory data among patients with suspected lymphoma (Aim 2), and longitudinal follow-up among those with confirmed hematologic malignancies receiving treatment under local conditions (Aim 3).
In Aim 1, Dr. Gopal will perform core lymph node biopsies on at least 200 consecutively enrolled patients with suspected lymphoma.
In Aim 2, Dr. Gopal will collect relevant clinical and laboratory data among patients at the time of enrollment and lymph node biopsy, and correlate these data with final histopathologic diagnosis.
In Aim 3, Dr. Gopal will perform systematic, longitudinal assessments for 2 years among those with confirmed hematologic malignancies to evaluate response to therapy, treatment-related toxicities, costs of treatment, and health-related quality o life (HRQOL) measures. The studies outlined in this proposal will form the basis for a multicenter clinical trial of lymphoma treatment in sub-Saharan Africa to be proposed in an R01 application before the end of the career development award period.

Public Health Relevance

The burden of lymphoma is rapidly increasing in sub-Saharan Africa, and current diagnostic and treatment strategies are inadequate. Improved understanding of the clinical and histopathologic features of lymphoma is critical to developing effective treatments which are feasible under local conditions in resource- limited settings.

National Institute of Health (NIH)
Fogarty International Center (FIC)
Research Scientist Development Award - Research & Training (K01)
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International and Cooperative Projects - 1 Study Section (ICP1)
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Jessup, Christine
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University of North Carolina Chapel Hill
Internal Medicine/Medicine
Schools of Medicine
Chapel Hill
United States
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Mabedi, C; Kendig, C; Liomba, G et al. (2014) Causes of cervical lymphadenopathy at Kamuzu Central Hospital. Malawi Med J 26:16-9
Achenbach, Chad J; Buchanan, Ashley L; Cole, Stephen R et al. (2014) HIV viremia and incidence of non-Hodgkin lymphoma in patients successfully treated with antiretroviral therapy. Clin Infect Dis 58:1599-606
Gopal, Satish; Patel, Monita R; Achenbach, Chad J et al. (2014) Lymphoma immune reconstitution inflammatory syndrome in the center for AIDS research network of integrated clinical systems cohort. Clin Infect Dis 59:279-86
Gopal, Satish; Achenbach, Chad J; Yanik, Elizabeth L et al. (2014) Moving forward in HIV-associated cancer. J Clin Oncol 32:876-80
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Gopal, Satish; Krysiak, Robert; Liomba, N George et al. (2013) Early experience after developing a pathology laboratory in Malawi, with emphasis on cancer diagnoses. PLoS One 8:e70361
Gopal, Satish; Patel, Monita R; Yanik, Elizabeth L et al. (2013) Association of early HIV viremia with mortality after HIV-associated lymphoma. AIDS 27:2365-73
Gopal, Satish; Patel, Monita R; Yanik, Elizabeth L et al. (2013) Temporal trends in presentation and survival for HIV-associated lymphoma in the antiretroviral therapy era. J Natl Cancer Inst 105:1221-9