Lymphoma in adolescents and young adults (AYA) accounts for 20-25% of cancer diagnosis in this age group. Historically, AYAs had inferior outcomes compared to paediatric and adults. Recent studies have demonstrated different disease features unique to AYA, though paucity in AYA cancer research remains. 

To investigate lymphoma epidemiology in AYA in Australia and report on disease features, therapeutic approaches, and outcome differences between AYA and older adults. 

Data from the LaRDR registry was retrospectively analysed to compare differences between AYA (aged 18-39) and adults (aged 40-60). We focussed on those diagnosed with classical Hodgkin lymphoma (cHL), DLBCL, PMBCL and Burkitt lymphoma between 2016 and April 2023.

cHL was the most common lymphoma diagnosis in AYA (68%), compared with 70% of adults affected with DLBCL (p<0.001). AYA patients with cHL had more favourable prognostic features, with majority of the AYAs having early-stage disease (p=0.003) and lower prognostic scores (HL-IPS) (p<0.001). In DLBCL, both AYA and adult patients had predominantly germinal-centre B cell lymphoma (GCB), with advance stages representing majority of the 2 populations (57% vs 60%, p>0.05). Overall survival (OS) was significantly better among AYA than in adult patients (p<0.001), and AYA had better 36-month progress-free survival (PFS) compared to adults (0.82 vs 0.73, p<0.001). 

AYA lymphoma patients displayed different disease subtypes, prognosis and outcomes, and this is consistent with other lymphoma studies acknowledging AYA as a distinct population. 

Utilising treatment regimens used in treating paediatric and adult lymphoma patients may be suboptimal for AYA patients. Mature long-term data are required to evaluate long-term toxicity.

 

Evangeline EW Wong1, Cameron CW Wellard2, Kirsty KR Rady1, Dipti DT Talaulikar1
 
 

1.     Department of Haematology, Canberra Health Services, Garran, ACT, 2605

2.     School of Public Health and Preventive Medicine, Monash University, Victoria, 3800