The Latin American Lymphoma Study Group (GELL): A Model of Collaborative Research in Latin America

El Grupo de Estudio Latinoamericano de Linfomas (GELL): Un Modelo de Investigación Colaborativa en América Latina | 拉丁美洲淋巴瘤研究组 (GELL)：拉丁美洲协作研究的典范

Abstract

Introduction

Collaborative health research has proven to be an effective approach to addressing regional and international challenges in the diagnosis, treatment, and management of diseases (1–4). In Latin America, a region characterized by geographic, socioeconomic, and epidemiological diversity, the creation of research networks is essential to unify efforts and generate knowledge applicable locally and internationally (1–4). In this context, the Latin American Lymphoma Study Group (GELL) emerges as a key player in lymphoma research—a family of hematologic cancers with high clinical and molecular heterogeneity.

Origins and Structure of GELL

Founded in 2018, GELL is a collaborative research network comprising 14 Latin American countries, supported by prestigious international institutions such as the Dana Farber Institute, MD Anderson Cancer Center, and Tampa General Hospital. The group’s primary objective is to conduct multicenter studies that provide high-quality epidemiological, clinical, and molecular data on various lymphoma subtypes.

GELL's leadership includes Dr. Brady Beltrán (Peru) as president, Dr. María Torres (Venezuela) as vice president, and Dr. Denisse Castro (Peru) as treasurer. This organizational structure enables efficient coordination among member countries, ensuring the planning and execution of clinical and translational studies across the region.

Objectives and Achievements of GELL

One of GELL's main objectives is to determine the epidemiology of different lymphoma subtypes in Latin America, including diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, nasal-type T/NK-cell lymphoma, and Epstein-Barr virus (EBV)-associated lymphoma. The group also aims to develop retrospective and prospective studies on inflammatory biomarkers and novel prognostic scores (5–7). These studies help identify risk factors and clinical parameters that predict treatment response and prognosis in lymphoma patients.

To date, GELL has collected data on more than 6,400 patients in retrospective studies, including:

• 1,500 patients with DLBCL (6,8).
• 1,000 patients with peripheral T-cell lymphoma (PTCL-NOS) (9).
• 800 patients with follicular lymphoma (10).
• 2,000 patients with adult T-cell leukemia/lymphoma (ATLL) (11).

These retrospective studies are crucial for generating hypotheses that guide future prospective studies, contributing to a better understanding of lymphomas in the region.

Scientific Production and Knowledge Dissemination

GELL has achieved remarkable scientific output, contributing 37 works that include:

• 6 articles published in high-impact journals.
• 30 posters presented at international conferences such as ASH, EHA, and the World HTLV-1 Congress.
• 4 oral sessions at international scientific events.

Among its most significant scientific achievements is the multicenter validation of the prognostic value of the neutrophil-to-lymphocyte ratio in DLBCL patients (12), published in collaboration with other international institutions. Additionally, GELL has developed consensus on relevant topics such as the management of patients with unspecified peripheral T-cell lymphoma (PTCL-NOS), which is in the process of publication, and the impact of COVID-19 on lymphoma patients (13).

The impact of GELL's scientific production is measured not only in terms of publications and presentations but also in its ability to influence clinical practice at the regional level. The creation of consensuses and participation in clinical trials ensure that GELL's findings are immediately applicable to patient care in Latin America.

Future Projects and GELL's Expansion

GELL is not content with its achievements and continues to expand its horizons towards new research projects. One of the most ambitious projects underway is a molecular study on the genetic profile of DLBCL in Latin America, which will analyze over 400 genes using the Foundation One–Heme platform. This will be the first study of its kind in the region, providing a detailed understanding of the genetic alterations characterizing lymphomas in Latin American patients.

Another significant project involves conducting prospective clinical trials on nasal-type T/NK-cell lymphoma and a meta-analysis on inflammatory biomarkers in lymphomas. These studies not only contribute to advancing scientific knowledge but also allow patients access to innovative treatments through clinical trials, promoting equity in access to advanced therapies.

International Collaboration

GELL has established collaborations with research groups from Japan, Brazil, and Italy, enabling it to build one of the largest global databases on T-cell lymphomas and EBV-associated DLBCL. These collaborations reflect the growing relevance of studies conducted in Latin America and position GELL as a global leader in lymphoma research.

Conclusion

The Latin American Lymphoma Study Group (GELL) has demonstrated that scientific collaboration in Latin America can generate valuable knowledge applicable globally. Its efforts to unify data from multiple countries, conduct prospective and retrospective studies, and promote participation in clinical trials have significantly improved the care of lymphoma patients in the region. With ambitious projects on the horizon, such as the molecular analysis of DLBCL and new clinical trials, GELL is well-positioned to continue leading lymphoma research in Latin America and beyond.