Clinical and biological aspects of aggressive B-cell non-Hodgkin lymphoma in adolescents and young adults

Abstract Adolescents and young adults (AYA) with cancer have been designated as a vulnerable population by the National Cancer Institute. This group, defined by the ages of 16-39 years, has not enjoyed the same survival improvements over the past several decades as older and younger cohorts. Several barriers prevent the optimal delivery of oncologic care in this subpopulation. This review will describe these challenges in the context of the major hematologic malignancies affecting this population (acute lymphoblastic leukemia [ALL], acute myeloid leukemia [AML], Hodgkin lymphoma [HL], and non-Hodgkin lymphoma [NHL]). For example, historical differences in care delivery between pediatric and adult health care systems have created confusion about optimal treatment planning for AYAs, a population that spans the pediatric-adult divide. In the case of ALL, retrospective studies have demonstrated significantly better outcomes when AYAs are treated according to pediatric and not adult protocols. Additional challenges more specific to AYAs include increased treatment-related toxicity relative to younger patients; less access to care and, specifically, access to clinical trials; lower adherence to medications and treatment plans; and psychosocial stressors relevant to individuals at this stage of life. Recognizing and responding to these challenges in AYAs may create opportunities to improve the cancer outcomes of this group.

Download Full-text

Sex-specific mortality trends in adolescents and young adults with cancer from 2007 to 2016.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.1570 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 1570-1570

Author(s):

Allison Close ◽

Brittani Seynnaeve ◽

Kimberly Miller ◽

Louis Rapkin

Keyword(s):

Young Adults ◽

Hodgkin Lymphoma ◽

Relative Survival ◽

Hematologic Malignancies ◽

Mortality Rates ◽

Adolescents And Young Adults ◽

Mortality Trends ◽

Men And Women ◽

Uterine Corpus ◽

Non Hodgkin Lymphoma

1570 Background: Adolescents and young adults (AYA) aged 15-39 years make up approximately 70,000 new oncology cases in the USA. Historically, mortality from cancer has smaller incremental improvements in AYA patients when compared to children and older adults, and not much is known about current sex-specific trends. We assessed overall and sex specific AYA mortality for the last 10 years (2007-2016). Methods: Trends in age-adjusted mortality rates per 100,000 (1972-2016) were obtained from the CDC’s National Center for Health Statistics (NCHS). Average annual percent changes (AAPCs) in relative survival were analyzed using NCI’s JPSurv webtool and mortality AAPCs were quantified using Joinpoint regression analysis. Results: Overall declines in mortality are similar in AYA men and women from 1972-2016, with 54% and 51% decline, respectively. In the most recent 10 years of data (2007 to 2016), combined sex AYA mortality AAPC’s declined by about 0.8% per year, slightly slower than declines in children <15 years (1.3% per year) and adults ages >40 years (1.5% per year). Among AYA males there have been 10 year AAPC mortality declines in leukemia (-1.8%), Hodgkin lymphoma (HL) (-5.1%), Non-Hodgkin lymphoma (NHL) (-4.1%) and melanoma of the skin (-3.4%). For AYA females, 10 year AAPC mortality declines occurred in leukemia (-1.9%), ovarian (-1.5%), HL (-10%), NHL (-4.9%) and melanoma (-2.8%). These declines have been offset by stable or increasing mortality rates for several common AYA cancers, including colorectal cancer (CRC) (1.1%) and bone and joint cancer (0.6%) in AYA males. AYA females have experienced mortality increases for CRC (0.6%), bone and joint cancer (0.5%) and uterine corpus cancer (2.8%). Conclusions: In general, mortality rates for both AYA men and women have declined over the past 10 years due to decreased mortality in hematologic malignancies and melanoma. Despite overall improvement, tumor categories in both AYA males and female such as CRC, bone and joint cancer, and uterine corpus cancers show increasing mortality. These diseases require specific investigations by both pediatric and adult researchers.

Download Full-text

Sequential Myeloablative Autologous Stem Cell Transplantation and Reduced Intensity Allogeneic Stem Cell Transplantation in Children, Adolescents and Young Adults with Poor Risk Refractory or Recurrent Hodgkin (HL) and Non-Hodgkin Lymphoma (NHL)

Biology of Blood and Marrow Transplantation ◽

10.1016/j.bbmt.2013.12.107 ◽

2014 ◽

Vol 20 (2) ◽

pp. S85 ◽

Cited By ~ 1

Author(s):

Prakash Satwani ◽

Zhezhen Jin ◽

Monica Bhatia ◽

James Garvin ◽

Diane George ◽

...

Keyword(s):

Young Adults ◽

Stem Cell ◽

Stem Cell Transplantation ◽

Hodgkin Lymphoma ◽

Cell Transplantation ◽

Autologous Stem Cell Transplantation ◽

Allogeneic Stem Cell Transplantation ◽

Adolescents And Young Adults ◽

Non Hodgkin Lymphoma ◽

Reduced Intensity

Download Full-text

Cancer risk among adolescents and young adults living with HIV in South Africa: a national cohort study

10.31730/osf.io/xq6jh ◽

2021 ◽

Author(s):

Yann Ruffieux ◽

Tafadzwa Dhokotera ◽

Mazvita Muchengeti ◽

Lina Bartels ◽

Victor Olago ◽

...

Keyword(s):

South Africa ◽

Cervical Cancer ◽

Young Adults ◽

Hodgkin Lymphoma ◽

Kaposi Sarcoma ◽

Adolescents And Young Adults ◽

Age Group ◽

Non Hodgkin Lymphoma ◽

Living With Hiv ◽

Cd4 Cell

Background: We studied the incidence of and risk factors for various types of cancers in adolescents and young adults living with HIV (AYALWH) in South Africa between 2004 and 2014. Methods: We included individuals aged 15 to 24 years from the South African HIV Cancer Match study, a large cohort resulting from a linkage between HIV-related laboratory measurements from the National Health Laboratory Services and records from the National Cancer Registry. We computed incidence rates for the most common cancers. We assessed associations between these cancers and sex, age, calendar year, and CD4 cell count using Cox models and adjusted hazard ratios (aHR).Findings: We included 782,454 AYALWH (89% female). Of those, 867 developed incident cancer including 429 who developed Kaposi sarcoma, 107 non-Hodgkin lymphoma, 48 Hodgkin lymphoma, 45 cervical cancer, and 32 leukaemia. Kaposi sarcoma was more common in the 20-24 year age group than the 15-19 year age group (aHR 1.39, 95% CI 1.03-1.86). Male sex was associated with higher rates of Kaposi sarcoma (aHR 2.06, 95% CI 1.61-2.63), non-Hodgkin lymphoma (aHR 3.17, 95% CI 2.06-4.89), Hodgkin lymphoma (aHR 4.83, 95% 2.61-8.93), and leukaemia (aHR 5.90, 95% CI 2.87-12.1). Lower CD4 cell counts at baseline were associated with higher rates of Kaposi sarcoma, cervical cancer, non-Hodgkin and Hodgkin lymphoma.Interpretation: Infection-related cancers are the most common cancer types among AYALWH in South Africa. The burden of these cancers may be reduced through HPV vaccination, targeted HIV testing, early initiation of antiretroviral therapy, and improvement of treatment adherence.

Download Full-text