Incidence and outcomes of lymphoid malignancies in adolescent and young adult patients in the United States

Abstract

Lymphoma incidence and survival in adolescent and young adult (AYA, defined as 15–39 years of age) and adult patients (>39 years) were assessed using Surveillance, Epidemiology, and End Results (SEER) data. From 2000 to 2014, 431 721 lymphoma cases were reported to SEER, 9% in AYA patients. In the AYA group, the highest age-adjusted incidence rate was for classical Hodgkin lymphoma [HL; 3·4 per 100 000 person-years; 95% confidence interval (CI), 3·38–3·49] followed by diffuse large B cell lymphoma (DLBCL; 1·56, 95% CI, 1·53–1·60) and for adults, it was plasma cell neoplasms (14·17, 95% CI, 14·07–14·27), DLBCL (13·86, 95% CI, 13·76–13·96) and chronic lymphocytic leukaemia (CLL; 13·19, 95% CI, 13·09–13·29). HL comprised 42% of lymphoma cases for AYAs, but only 4% in adults. The occurrence of DLBCL among AYAs and adults was similar, 18% and 20%, respectively. Twenty-eight percent of AYAs compared with 9% of adults presented with stage II disease, and 21% of AYAs compared with 10% of adults had B-symptoms. Extranodal disease was less common (33%) in AYAs than adults (59%). Overall, AYA patients with lymphoma have better 2- and 5-year relative survival rates (RSRs) compared to adults. When restricted to HL and DLBCL, RSR of AYA patients exceeds adult RSR.