Real-World Outcomes of Adolescents and Young Adults with Diffuse Large B-Cell Lymphoma: A Multicenter Retrospective Cohort Study

Denisse Castro-Uriol, Departamento de Oncología y Radioterapia, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru.
Ligia Rios, Unidad de Oncología Pediátrica y del Adolescente, Departamento de Oncología y Radioterapia, Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú.
Daniel Enriquez-Vera, Division of HTLV-1/ATL Carcinogenesis and Therapeutics, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan.
Jacqueline Montoya, Departamento de Oncología Pediátrica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.
Thanya Runciman, Departamento de Oncología y Radioterapia, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru.
Sandra Alarcón, Departamento de Oncología Pediátrica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.
Arturo Zapata, Departamento de Oncología Pediátrica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.
Eddy Hernández, Departamento de Oncología Pediátrica, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.
Esmeralda León, Unidad de Oncología Pediátrica y del Adolescente, Departamento de Oncología y Radioterapia, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú.
Luis Malpica, Division of Cancer Medicine, Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Bryan Valcarcel, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia, USA.

Document Type

Journal Article

Publication Date

10-16-2023

Journal

Journal of adolescent and young adult oncology

DOI

10.1089/jayao.2023.0095

Keywords

adolescents; cohort studies; diffuse large B cell lymphoma; outcomes; young adults

Abstract

Patients with diffuse large B-cell lymphoma (DLBCL) are typically treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). However, a standard of care for managing adolescents and young adults (AYAs) with DLBCL is lacking. We examine treatment approaches and outcomes of this population. We included 90 AYAs (15-39 years) diagnosed with DLBCL between 2008 and 2018 in three tertiary centers in Peru. Overall response rates (ORR) were available for all patients. Overall survival (OS) and progression-free survival (PFS) rates were estimated using the Kaplan-Meier method. The median age at diagnosis was 33 years, 57% were males, 57% had good performance status (Lansky/Karnofsky ≥90), and 61% were diagnosed with early-stage disease (Ann Arbor stages I-II). R-CHOP ( = 69, 77%) was the most frequently used first-line regimen, with an ORR of 91%. With a median follow-up of 83 months, the 5-year OS and PFS among all patients were 79% and 67%, respectively. Among the patients who received R-CHOP, the 5-year OS and PFS were 77% and 66%, respectively. Of the 29 (32%) patients with relapsed/refractory (R/R) disease, 83% received second-line treatment and only 14% underwent consolidation therapy with autologous transplantation. The 3-year OS for R/R DLBCL was 36%. Our data show that AYAs with DLBCL who received conventional therapy had comparable outcomes to those observed in studies conducted among the adult population. However, the prognosis for AYAs with R/R disease was dismal, indicating the unmet need for developing and increasing access to novel treatment modalities in AYAs.

Department

Public Health Student Works

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