Clinical characteristics and outcome of mycosis fungoides among children, adolescents, and young adults: Single institution study.

e19576 Background: Mycosis fungoides (MF) is the most common subtype of cutaneous T cell lymphoma (CTCL) [1]. MF is characterized by the skin infiltrate of small to medium size T lymphocytes with cerebriform nuclei. The incidence of MF increases significantly with age, with a median age at diagnosis of 60 years, and predominantly in white males [2]. The clinical outcome has not been evaluated among children, adolescents, and young adults. This study aimed to evaluate the characteristics and outcomes in this population. Methods: We retrospectively reviewed clinical data on 90 patients with MF at Moffitt Cancer Center between 2000 and 2020. Fifteen patients were diagnosed before the age of 20 years. Our cohort was compared to the largest US epidemiological report by Nath et al. using SEER database, which consists of 4892 patients from 1998-2008 [2]. The Chi-square test was used for comparison. Overall survival (OS) was calculated from diagnosis until death or last contact. OS between different groups was compared using the Kaplan-Meier curve. Hazard ratio and p-value were calculated using the log-rank test. Results: Of 90 patients, the median age at diagnosis was 32 years (range 6-39). The male to female ratio was 1.3:1. White and black races account for 57% and 27% of the patients. Compared to historical control, black patients were significantly higher in the current cohort (27% vs. 13%, p < 0.001). The difference widened in children and adolescents. More patients present with early stage MF in the current cohort (95.6% vs. 83%, p = 0.003). Clinical characteristics, including stage, LDH, WBC, ferritin level, were similar between children/adolescents and young adults. However, our cohort had significantly higher CD8 positive MF, and nearly half of children and adolescents were CD8 positive. Young adults had a higher rate of coexisting skin malignancy; however, this was not statistically significant due to small patient size. Time to diagnosis remained long, especially in children and adolescents’ group. However, the outcome is excellent. At a median follow-up of 4.9 years, four patients deceased, and the median OS was not reached. The prognosis remains poor in patients with advanced disease (HR = 39, p < 0.001) and large cell transformation (LCT) (HR = 8.5, p = 0.009). Conclusions: Compared to historical cohorts, higher proportion of black and female patients were noted in our young cohort with more early-stage and CD8 positive disease. This observation likely represents the different underlying biology of the disease [3]. Clinical outcome in young patients was excellent. However, patients with LCT or advanced stage carry a poor prognosis and need better therapies.

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Osteosarcoma in Adolescents and Young Adults

Cells ◽

10.3390/cells10102684 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2684

Author(s):

Jun Ah Lee ◽

Jiwon Lim ◽

Hye Young Jin ◽

Meerim Park ◽

Hyeon Jin Park ◽

...

Keyword(s):

Young Adults ◽

Young Children ◽

Clinical Characteristics ◽

Local Treatment ◽

Age Groups ◽

The Elderly ◽

Adolescents And Young Adults ◽

Dependent Manner ◽

Female Ratio ◽

Male To Female

The epidemiology of osteosarcoma in adolescents and young adults (AYA) remains unclear. We aimed to assess and compare the clinical features of osteosarcoma between AYA and other age groups. We retrieved osteosarcoma cases diagnosed between 1999 and 2017 from the Korea Central Cancer Registry. We compared survival trends and clinical characteristics between AYA and other age groups. AYA comprised 43.3% (1309/3022) of the osteosarcoma cases. Compared to other age groups, the male-to-female ratio was highest in AYA (1.61:1). The proportion of tumors located in an extremity was 80.3% in AYA, which was lower than in young children (92.5%) or pubertal children (93.8%) but higher than in adults (55.7%) or the elderly (47.5%). As for treatments, 71.2% of AYA received local treatment and systemic chemotherapy, and 28.8% received only local treatment (surgery: 261, radiotherapy: 9, surgery and radiotherapy: 5). The 5-year overall survival (OS) was lower in AYA (68%) than in young children (78%) or pubertal children (73%) but higher than in adults (47%) or the elderly (25%). When AYA were divided into five subgroups by age, patients aged 15–19 years constituted the largest proportion (45.4%, n = 594). Additionally, the proportion of patients with a non-extremity tumor increased in an age-dependent manner, from 10.3% in AYA aged 15–19 years to 35.3% in AYA aged 35–39 years. OS did not significantly differ among the different age subgroups of AYA. The clinical characteristics and OS of the AYA were more similar to those of children than to those of adults. There is a need for cooperation between pediatric and adult oncologists for effective osteosarcoma treatment in AYA.

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Evaluation of IL1β and IL6 Gingival Crevicular Fluid Levels during the Early Phase of Orthodontic Tooth Movement in Adolescents and Young Adults

Applied Sciences ◽

10.3390/app11020521 ◽

2021 ◽

Vol 11 (2) ◽

pp. 521

Author(s):

Simina Chelărescu ◽

Petra Șurlin ◽

Mioara Decusară ◽

Mădălina Oprică ◽

Eugen Bud ◽

...

Keyword(s):

Young Adults ◽

Orthodontic Treatment ◽

Tooth Movement ◽

Gingival Crevicular Fluid ◽

Early Stage ◽

Statistical Tests ◽

Orthodontic Tooth Movement ◽

Adolescents And Young Adults ◽

Periodontal Tissues ◽

Crevicular Fluid

Background: The crevicular fluid analysis represents a useful diagnosis tool, with the help of which noninvasive cellular metabolic activity can be analyzed. The aim of the study is to investigate comparatively IL1β and IL6 in the gingival crevicular fluid of clinically healthy adolescents and young adults during the acute phase of orthodontic treatment. Methods: Gingival crevicular fluid was collected from 20 patients (aged between 11 and 28) undergoing orthodontic treatment. Measurements were taken before (T0) and after 24 h after distalization forces were activated (T1). IL1β and IL 6 were analyzed using Elisa tests. The statistical tests used were two-sided t tests. Results: Between the two time periods there was a significant raise both in the crevicular fluid rate (0.57 µL at T0 vs. 0.95 µL at T1, p = 0.001) and in IL1β levels (15.67 pg/µL at T0 vs. 27.94 pg/µL at T1, p = 0.009). We were able to identify IL6 only in a third of the sites. There is a significantly increased level of ILβ at T1 in adolescents, more than in young adults (42.96 pg/µL vs. 17.93 pg/µL, p = 0.006). Conclusions: In the early stage of orthodontic treatment, the periodontal tissues of adolescents are more responsive to orthodontic forces than those of young adults.

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Epidemiological and Clinical Characteristics of COVID-19 in Adolescents and Young Adults

The Innovation ◽

10.1016/j.xinn.2020.04.001 ◽

2020 ◽

Vol 1 (1) ◽

pp. 100001 ◽

Cited By ~ 20

Author(s):

Jiaqiang Liao ◽

Shibing Fan ◽

Jing Chen ◽

Jianglin Wu ◽

Shunqing Xu ◽

...

Keyword(s):

Young Adults ◽

Clinical Characteristics ◽

Adolescents And Young Adults

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Outcome of Transitioning Pediatric Patients with Sickle Cell Disease to Adult Programs.

Blood ◽

10.1182/blood.v104.11.3743.3743 ◽

2004 ◽

Vol 104 (11) ◽

pp. 3743-3743 ◽

Cited By ~ 3

Author(s):

Samir K. Ballas ◽

Carlton Dampier

Keyword(s):

Chronic Pain ◽

Young Adults ◽

Pain Management ◽

Sickle Cell Disease ◽

Medical Care ◽

Sickle Cell ◽

Adolescents And Young Adults ◽

Cell Disease ◽

Adult Care ◽

Female Ratio

The transition of medical care of patients with sickle cell disease (SCD) from pediatric to adult providers represents a milestone in their lives. Major concerns among adolescents and young adults about transition include taking responsibility for self, making own decisions, cost of medical care, fear of suboptimal pain management, and reluctance to leave known providers. In this study we present our experience in the process of transition to adult care and its outcome over the last ten years. Adolescents and young adults were given information about the nature of medical care provided by adult internists and hematologists. The sickle cell programs available in the city were described. Moreover, site visits to the hospitals where adult care was to be provided were arranged. During these visits, adolescents and young adults had the chance to meet the hematologist and other potential providers and ask questions, visit the emergency room, the clinic, and the sickle day unit if applicable. Patients were empowered to choose the program to which they wished to be transitioned. During the last 10 years, 90 adolescents and young adults (See Table) with SCD (Sickle Cell Anemia [SS], Hemoglobin SC Disease, and Sickle Thalassemia [ST]) were transitioned to the adult sickle cell program of Thomas Jefferson University. Age of transition varied between 18 and 25 years. Eighteen patients (20%) died. Age at death was 24.9 ± 2.95 years and the male/female ratio was 10:8. Complications of sickle cell disease after transition included leg ulcers, stroke, avascular necrosis, anxiety, depression, and priapism. Nineteen patients (10 males, 9 females) were employed. Twenty-nine (32%) patients developed chronic pain syndrome and its sequelae. Many patients failed to achieve their childhood goals. The data show that a significant number of patients die within 10 years after transition. The quality of life of survivors is suboptimal and drifts into issues of chronic pain management in the adult environment. Identifying these issues may provide predictors that identify children at risk to have undesirable outcomes after transition. Aggressive management and refining the process of transition should improve the outcome after transition. Distribution of the Transitioned Patients SS SC ST Total Male 31 8 4 43 Female 34 8 5 47 Total 65 16 9 90

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Survival in Adolescents and Young Adults with Hodgkin Lymphoma Treated with Response-Based Chemotherapy on P9425 and P9426 Protocols: A Report From the Children's Oncology Group

Blood ◽

10.1182/blood.v118.21.91.91 ◽

2011 ◽

Vol 118 (21) ◽

pp. 91-91 ◽

Cited By ~ 2

Author(s):

Karen S. Fernández ◽

Lu Chen ◽

Cindy Schwartz ◽

Allen R. Chauvenet ◽

Pedro A. de Alarcón

Keyword(s):

Young Adults ◽

Hodgkin Lymphoma ◽

Adolescents And Young Adults ◽

High Dose ◽

Oncology Group ◽

Term Survival ◽

Female Ratio ◽

Dose Dense ◽

Dose Radiation

Abstract Abstract 91 Background: Hodgkin Lymphoma (HL) is a highly curable malignancy affecting all age groups with a bimodal distribution with peaks between the 2nd and 3rd decade of life and at over 60 years of age. Children and adolescents with HL treated according to recent Pediatric Oncology Group (POG) regimens received dose dense, response-based chemotherapy with low dose radiation, decreasing both cumulative doses of chemotherapy and radiation. Treatment of adolescents and young adults (AYA) has not been consistent, with choice of adult vs. pediatric regimens depending on the referral pattern and institutional polices. The German Cooperative group reported equivalent results in the AYA group vs. adults using an adult focused protocol that included high dose alkylator therapy and high dose radiation, and used that data to recommend adult therapy for AYA. We evaluated the outcome of Pediatric vs. AYA patients in two POG trials to assess the utility of pediatric regimens for AYA HL. Purpose and Methodology: We retrospectively analyzed POG studies P9425 and P9426 to compare the survival rate of children (<15 year of age) and AYA (15 – 20 years of age) with HL. P9425 included 216 patients (104 AYA) with intermediate (IB, IIA/IIIA1 with large mediastinal adenopathy or IIIA2) or high-risk (IIB, IIIB, IV) biopsy-proven classical HL. A response-based treatment approach administered doxorubicin, bleomycin, vincristine, etoposide, prednisone and cyclophosphamide (ABVE-PC) every 21 days. Rapid early responders (RER) to 3 ABVE-PC cycles received 21 Gy radiation to involved regions. Slow early responders (SER) received 2 additional ABVE-PC cycles before 21 Gy radiation. As previously published, this dose dense regimen resulted in excellent event-free and overall survival (EFS, OS) regardless of the risk assignment and early response. Five-year EFS 84%; 86% for RER, 83% for SER (P = 0.85). Five-year OS was 95%. P9426 study included 255 patients, (99 AYA) with low risk (Stage IA, IIA and IIIA) biopsy-proven HL. Chemotherapy was a response-based approach that utilized doxorubicin, bleomycin, vincristine and etoposide (ABVE) every 28 days. RER to 2 DBVE cycles received 25.5 Gy involved field irradiation. SER received 2 additional cycles of ABVE followed by irradiation. The 5-year EFS for early stage HL under this protocol was 87.8%. 5-year OS was 97.6%. Results: Of 471 eligible patients treated on POG 9425 and 9426, 203 were AYA. Table 1 shows patient characteristics. Male to female ratio was similar in both groups. The most common histology in both groups was nodular sclerosing. Mixed cellularity and lymphocyte predominant subtypes were more common in children less than 15 years of age. There was no difference in EFS for the younger vs. older patients. Figure 1. Conclusions: The outcome of adolescents treated on P9425 and P2496 with dose dense, response-based treatment and reduced dose irradiation was not different from the outcome of children less than 15 years of age. The cumulative doses of alkylators, anthracyclines, and epipodophyllotoxins used in these pediatric protocols are below thresholds usually associated with significant long-term toxicity. These data validate our preference for the treatment AYA and adolescents with HL using pediatric-focused therapy. This approach may reduce the risk for late adverse effects (cardiotoxicity, infertility, secondary malignancy) by limiting cumulative doses of alkylator agents, anthracyclines and radiation therapy. A focus on dose-limited regimens is critically important for younger patients (pediatric and AYA) who are expected to have long-term survival. Disclosures: No relevant conflicts of interest to declare.

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Clinical characteristics of melanoma in an ethnically diverse population of adolescents and young adults.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e21043 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e21043-e21043

Author(s):

Kimberly Ann Miller ◽

Anthony Pham ◽

Jacob Stephen Thomas ◽

Myles G Cockburn ◽

David Robert Freyer ◽

...

Keyword(s):

Young Adults ◽

Los Angeles ◽

Clinical Characteristics ◽

Ethnically Diverse ◽

Adolescents And Young Adults ◽

P Value ◽

Diverse Population ◽

Acral Lentiginous Melanoma ◽

Significant Difference ◽

Melanoma Patients

e21043 Background: Melanoma is the third most common cancer among adolescents and young adults (AYAs; aged 15-39). Disease characteristics have not been well-described in this age group, particularly among diverse populations. We describe clinical features of AYAs diagnosed with melanoma at a large public hospital serving an ethnically diverse population. Methods: We reviewed medical chart data from patients diagnosed with melanoma between 2001-2016 at Los Angeles County + USC Medical Center. We describe clinical characteristics of AYA patients and compare to non-AYAs (aged ≥40) using Fisher’s exact test. A p-value < 0.05 was considered statistically significant. Results: Of the 273 melanoma patients identified, 47 (17.3%) were AYAs (mean age 32.3; SD±4.45; lower age range 18). The majority of patients were Hispanic (AYA, 53.2%; non-AYA, 51.1%), followed by non-Hispanic whites (AYA, 38.3%; non-AYA, 38.7%). A greater proportion of AYA patients were female (59.6%) compared to non-AYAs (38.2%) (p < 0.01). No AYA patients reported prior skin cancer compared to 19.9% of non-AYAs; 8.5% of AYAs reported family history of melanoma compared to 6.3% of non-AYAs. For all patients, superficial spreading melanoma was the most common histological subtype (AYA, 21.3%; non-AYA, 20.9%). Nodular melanoma was the second most common subtype in AYAs (17.02%) in contrast to acral lentiginous melanoma among non-AYAs (20.9%). Median Breslow depth was 3.0 mm for AYAs and 2.55 mm among non-AYAs. A slightly higher percentage of AYAs were diagnosed with regional disease (31.9%) than non-AYAs (24.4%), and a greater proportion of non-AYAs presented with distant metastases (AYA, 6.4%; non-AYA, 18.7%). The most common site of diagnosis were the extremities for all patients (AYA, 45.0%; non-AYA, 29.3%). Conclusions: We found similar clinical characteristics between AYA and non-AYA melanoma patients. However, we found a statistically significant difference for gender. The increased incidence of melanoma in female AYAs may be driven by biological factors such as sex hormones or genotype, or tanning behaviors. Further research is warranted to identify predictive and prognostic factors of melanoma among diverse AYAs, particularly females.

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Wellness Matters: Promoting Health in Young Adults

Kinesiology Review ◽

10.1123/krj.2.1.39 ◽

2013 ◽

Vol 2 (1) ◽

pp. 39-46 ◽

Cited By ~ 2

Author(s):

Barbara E. Ainsworth ◽

Cheryl Der Ananian

Keyword(s):

Young Adults ◽

Primary Prevention ◽

Life Course ◽

Children And Adolescents ◽

Millennial Generation ◽

Cultural Influences ◽

Chronic Illnesses ◽

Adolescents And Young Adults ◽

Cohort Effects ◽

Course Experiences

There is a growing recognition of the need for the primary prevention of chronic illnesses across the lifespan. In recent years, diseases that were formerly associated with adulthood such as diabetes are being diagnosed in adolescents and young adults. While there have been many prevention efforts focusing on health in children and adolescents, there is a limited body of research examining prevention in young adults. This article examines the concept of wellness in the Millennial generation and describes how their life course experiences impact seven domains of wellness. Specifically, this article describes the period and cohort effects that influence the domains of wellness and how the Millennial generation differs from other generations in these aspects of wellness. Finally, this paper provides an overview of the technological and cultural influences on wellness in the Millennial generation.

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