Clinical characteristics and outcomes of diffuse large B-cell lymphoma in adolescents and young adults
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Clinical information regarding non-Hodgkin lymphoma (NHL) in adolescents and young adults (AYA) is lacking. We retrospectively analyzed 1426 consecutively registered patients with newly diagnosed NHL. Of 798 DLBCL patients, 42 (5.3%) were identified as AYA (16–39 years). The characteristics of AYA DLBCL patients showed no significant differences compared to older adult DLBCL patients (age ≥ 40 years). Progression-free survival (PFS) and overall survival (OS) in AYA were similar to those in patients aged 40–60 years. However, in older adult groups, PFS and OS were significantly different according to the age group (40–60, 61–79, and ≥ 80 years). In univariate analysis in AYA, performance status, clinical stage, International Prognostic Index (IPI), and age-adjusted IPI significantly affected both PFS and OS. In multivariate analysis, only clinical stage was identified as an independent predictor among AYA. In conclusion, disease characteristics and outcomes of DLBCL in AYA were nearly the same as those in older adults.
KeywordsNon-Hodgkin lymphoma Diffuse large B-cell lymphoma Adolescents Young adults Clinical practice
This work was supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization. We thank all the participating centers and collaborators of Clinical Hematology Group of National Hospital Organization (CHG-NHO); NHO Hokkaido Medical center, NHO Mito Medical center, NHO Matsumoto Medical center, NHO Kanazawa Medical center, NHO Himeji Medical center, NHO Minami-Okayama Medical center, NHO Hiroshima-Nishi Medical center, and NHO Nagasaki Medical center, for the registration of patients.
HN designed the research; TY, YoS, HIw, MH, MO, KS, NI, MS, TI, and HIi provided the data and contributed to patient care; Ya.S. and HN analyzed and interpreted the data and wrote the manuscript; and all the authors reviewed and revised the manuscript.
Compliance with ethical standards
Hirokazu Nagai has received research funding from Janssen Pharmaceutical K. K., Mundipharma K.K., Celgene Corporation, Bayer Yakuhin Ltd., Abbvie G.K., Takeda Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., and Esai Co., Ltd., and honoraria from Chugai Pharmaceutical Co., Ltd., Mundipharma K.K., Esai Co., Ltd., Sanofi K.K., and Janssen Pharmaceutical K. K. Kazutaka Sunami has received research funding from MSD K. K., Celgene Corporation, and honoraria from Celgene Corporation, Ono Pharmaceutical Co., Ltd., Bristol-Myers Squibb. Morio Sawamura has received honoraria from Ono Pharmaceutical Co., Ltd. and Takeda Pharmaceutical Co., Ltd.
- 4.Bleyer WA, O’Leary M, Barr R, Ries LAG. Cancer epidemiology in older adolescents and young adults 15–29 years of age, including SEER incidence and survival, 1975–2000. Bethesda: National Cancer Institute, NIH Pub. No. 06-5767; 2006.Google Scholar
- 9.Jaffe ES, Harris NL, Stein H, Vardiman JW. Pathology and genetics of tumours of haematopoietic and lymphoid tissues. Lyon: IARC Press; 2001.Google Scholar
- 16.Stock W, La M, Sanford B, Bloomfield CD, Vardiman JW, Gaynon P, et al. What determines the outcomes for adolescents and young adults with acute lymphoblastic leukemia treated on cooperative group protocols? A comparison of Children’s Cancer Group and Cancer and Leukemia Group B studies. Blood. 2008;112:1646–54.CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Hayakawa F, Sakura T, Yujiri T, Kondo E, Fujimaki K, Sasaki O, et al. Markedly improved outcomes and acceptable toxicity in adolescents and young adults with acute lymphoblastic leukemia following treatment with a pediatric protocol: a phase II study by the Japan Adult Leukemia Study Group. Blood Cancer J. 2014;4:e252.CrossRefPubMedPubMedCentralGoogle Scholar
- 19.Johnson NA, Slack GW, Savage KJ, Connors JM, Ben-Neriah S, Rogic S, et al. Concurrent expression of MYC and BCL2 in diffuse large B-cell lymphoma treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone. J Clin Oncol. 2012;30:3452–9.CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Green TM, Young KH, Visco C, Xu-Monette ZY, Orazi A, Go RS, et al. Immunohistochemical double-hit score is a strong predictor of outcome in patients with diffuse large B-cell lymphoma treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone. J Clin Oncol. 2012;30:3460–7.CrossRefPubMedGoogle Scholar
- 23.Oschlies I, Klapper W, Zimmermann M, Krams M, Wacker HH, Burkhardt B, et al. Diffuse large B-cell lymphoma in pediatric patients belongs predominantly to the germinal-center type B-cell lymphomas: a clinicopathologic analysis of cases included in the German BFM (Berlin–Frankfurt–Munster) Multicenter Trial. Blood. 2006;107:4047–52.CrossRefPubMedGoogle Scholar
- 24.Miles RR, Raphael M, McCarthy K, Wotherspoon A, Lones MA, Terrier-Lacombe MJ, et al. Pediatric diffuse large B-cell lymphoma demonstrates a high proliferation index, frequent c-Myc protein expression, and a high incidence of germinal center subtype: report of the French–American–British (FAB) International Study Group. Pediatr Blood Cancer. 2008;51:369–74.CrossRefPubMedPubMedCentralGoogle Scholar