Differences in Observed Outcomes and Toxicities for Adolescent and Young Adult Patients With Aggressive Mature B-Cell Lymphomas Treated at an Adult Versus Pediatric Cancer Center.
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BACKGROUND: Treatments for adolescent and young adult (AYA) patients with mature B-cell lymphomas (MBCL) differ between adult versus pediatric centers, and data are scarce regarding comparative toxicities and outcomes. PROCEDURES: We identified AYA patients (age 12-39) with MBCL seen between 2011 and 2021 at an adult (AC) and pediatric (PC) tertiary cancer center. Data regarding baseline characteristics, adverse events, and long-term outcomes were collected. RESULTS: A total of 173 AYA patients with MBCL were identified, 20 in the PC and 153 in the AC. During treatment, more unplanned hospitalizations (80% vs. 49%, p = 0.008), febrile neutropenia (70% vs. 42%, p = 0.04), Grade ≥3 mucositis (35% vs. 12%, p = 0.014), and fungal infections (15% vs. 3%, p = 0.040) were observed at PC versus AC, while neuropathy was less common (0% vs. 23%, p = 0.015). Two-year overall survival (OS) and progression-free survival (PFS) for those with Burkitt lymphoma were 92%, whereas those with diffuse large B-cell lymphoma (DLBCL) had 2-year OS and PFS of 92% and 76%, respectively. CONCLUSIONS: Among patients with DLBCL, pediatric-inspired or more intensive therapies were associated with improved PFS compared with R-CHOP, hazard ratio of 0.33 (95% confidence interval: 0.11-0.98). Greater short-term toxicity and lower incidence of peripheral neuropathy were observed in AYA MBCL patients treated at a pediatric versus adult center.