By Michael Gwarisa
A groundbreaking new study published in The Journal of Immunology has unveiled how Plasmodium falciparum malaria, the deadliest strain of the parasite, contributes directly to the development of Burkitt lymphoma (BL) — the most common childhood cancer in equatorial Africa and New Guinea. The findings offer the strongest evidence yet linking malaria and childhood cancer, and could have far-reaching implications for cancer prevention strategies in malaria-endemic regions like Zimbabwe.
Although scientists have long observed a correlation between P. falciparum malaria and Burkitt lymphoma, the biological mechanism behind this link had remained elusive since the association was first noted in 1958. Now, thanks to research led by Dr. Rosemary Rochford, Distinguished Professor of Immunology and Microbiology at the University of Colorado Anschutz School of Medicine, that mystery is closer to being solved.
Knowing that malaria has a direct role in increasing childhood cancer risk means that measures to reduce the burden of P. falciparum malaria in Africa could also reduce the incidence of Burkitt lymphoma,” said Dr. Rochford.
Burkitt lymphoma is a fast-growing cancer that affects B cells, which are immune cells responsible for producing antibodies. While BL is rare globally, it occurs at rates up to ten times higher in areas where P. falciparum malaria is endemic. Unlike other forms of malaria, only P. falciparum has been linked to BL.
The study focused on an enzyme known as activation-induced cytidine deaminase (AID), which plays a crucial role in the development of BL. According to the research team, elevated levels of AID were found in the B cells of children infected with P. falciparum, even in cases of uncomplicated malaria — where symptoms are non-specific and relatively mild, such as fever, chills, nausea, and headaches.
“AID is essential for a genetic mutation known as MYC translocation, a defining characteristic of Burkitt lymphoma,” said Dr. Rochford. “The presence of fully functional and elevated AID in malaria-infected children suggests a direct biological mechanism linking P. falciparum malaria to this cancer.”
MYC translocation occurs when a segment of DNA breaks off one chromosome and attaches to another, leading to uncontrolled cell growth — a hallmark of cancer. The study compared blood samples from children with and without malaria and found that AID was not only higher in children with malaria but also functionally active, supporting the idea that malaria may help initiate the cancer-causing mutation.
The implications of these findings are significant for public health in Africa, where both malaria and childhood cancers continue to pose major health challenges. In Zimbabwe, for example, efforts to eliminate malaria have seen notable progress over the years, but outbreaks still occur in high-burden districts, especially during the rainy season. The new findings add urgency to ongoing malaria control efforts by highlighting a link between infection and long-term cancer risk.
Dr. Rochford emphasized that this is just the beginning of a wider research agenda. Her team is now investigating how P. falciparum may affect other aspects of immune function in children, and how these changes could create an environment conducive to the development of various cancers, including other forms of non-Hodgkin’s lymphoma.
“We hope this study adds to the growing body of literature pointing to a critical role of AID in the etiology of Burkitt lymphoma and potentially in other lymphomas as well,” she said.
The study was published in The Journal of Immunology and is accessible through the American Association of Immunologists (AAI). Requests for full-text copies or interviews with the researchers can be directed to kpalmer@aai.org.
The American Association of Immunologists, which supported this study, is among the world’s leading organizations advancing immunological science and education. Their work has been pivotal in shaping life-saving innovations like antibody therapies, cancer immunotherapy, vaccines, and transplant technologies.
