PB2069 RETROSPECTIVE ANALYSIS OF ADOLESCENT AND YOUNG ADULT (AYA) WITH LYMPHOMA IN JAPAN
Authors: Nakaya A. , Ishii K. , Fujita S. , Satake A. , Nakanishi T. , Azuma Y. , Tsubokura Y. , Saito R. , Konishi A. , Hotta M. , Yoshimura H. , Ito T. , Nomura S. 
Published: June 2019

Background:

The concept of the adolescent and young adult period has only recently emerged. Most important activities in human life, such as attending school, starting work, marrying, and becoming pregnant, are done in this period. It has therefore become usual to think about this group separately from children and adults. However, in Japan, treatment of lymphoma in this group is split between pediatrics and hematology. This results in poor information‐sharing and some confusion about who should treat and follow this group. The move from pediatrics to hematology is often not smooth. There is therefore no precise data about lymphoma in this group collected in Japan.

Aims:

We therefore aimed to clarify the prevalence of lymphoma subtype, outcomes, and long‐term adverse events in this group.

Methods

We retrospectively analyzed 50 patients aged from 16 to 39 years old, who were diagnosed with lymphoma at Kansai Medical University Hospital and Kansai Medical University Medical Center from July 2004 to July 2018.

Results:

Their median age was 34 (16–39) years old and 62% were male. The median follow‐up period was 67 (0.3–176) months. The most frequent type of lymphoma was B cell lymphoma (58%), following Hodgkin lymphoma (24%), and T cell lymphoma (18%) (Table 1). The most frequent subtype of B cell lymphoma was diffuse large B cell lymphoma (DLBCL), followed by follicular lymphoma, Burkitt lymphoma, and lymphoblastic lymphoma. The most frequent T cell lymphoma was mycosis fungoides, then peripheral T‐cell lymphoma, not otherwise specified (PTCL, NOS), followed by cutaneous T cell lymphoma, extranodal NK/T‐cell lymphoma (ENKL), nasal type, and anaplastic large cell lymphoma, ALK positive. Median overall survival (OS) and progression free survival (PFS) are not achieved. 3‐year OS was 91.2 (78.1‐96.6) % and 3‐year PFS was 70.8 (54.9‐81.9) %. Over all response rate was 85.4%. Mortality was 12.5%, and the cause of death in each case was disease progression. Relapse rate was 31.3%. Among relapsed patients, four received a stem cell transplantation (two autologous and two allogeneic). Late onset adverse events were seen in six patients and were secondary breast cancer, hepatitis B virus reactivation, interstitial pneumonia, recurrent herpes zoster (all one case), and infertility (three cases; two female and one male). Five patients are still under treatment, and the patient with interstitial pneumonia died of disease progression. There were two patients who had sperm preservation, whereas, no patient had ovum preservation prior to treatment.

Summary/Conclusion:

We found that the most frequent type of lymphoma was B cell lymphoma, following Hodgkin lymphoma, and T cell lymphoma. More T cell lymphomas were seen in Japan than western countries. 3‐year OS was 91.2% and 3‐year PFS was 70.8%. Late onset adverse events were seen in six patients and were secondary breast cancer, hepatitis B virus reactivation, interstitial pneumonia, recurrent herpes zoster, and infertility. It is urgent necessary to expand awareness of their needs among healthcare workers and clarify who should treat them, as well as provide a suitable system to treat them.

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