Henderson TO et al. -There is no clear consensus about the treatment of adolescents and young adults (AYAs) with Hodgkin lymphoma (HL).Younger AYA patients with HL were shown to have better outcomes when treated on a pediatric trial than patients of similar age on an adult trial.

Methods

• Failure-free survival (FFS) and overall survival (OS) were compared between 114 patients (17-21 years of age) with HL who were treated on the Eastern Cooperative Oncology Group-American College of Radiology Imaging Network Intergroup adult E2496 study and 391 patients (17-21 years of age) with HL who were treated on the pediatric Children's Oncology Group (COG) AHOD0031 study.

Results

• There were no significant differences in extralymphatic disease, anemia, or hypoalbuminemia between AYAs from the COG and E2496 studies.
• More AYAs in the E2496 trial had stage III and IV disease (63% vs. 29%) and B symptoms (63% vs. 27%), and fewer had bulk disease (33% vs. 77%).
• More AYAs on the COG trial received radiotherapy (76% vs. 66%). The
• The 5-year FFS and OS rates were 68% and 89%, respectively, in the E2496 AYAs, and 81% and 97% in the COG AYAs, respectively.
• E2496 AYAs had worse FFS than COG AYAs in all strata except patients who had stage I and II HL without anemia.
• Propensity score analysis confirmed inferior FFS for E2496 AYAs compared with COG AYAs.
• On the E2496 study, FFS was significantly divergent across age groups, with inferior outcomes for those 17-21 years of age versus 22-44 years of age.
• There was no difference across age on the COG study.