Catherine Bollard, MBChB, MD, FRACP, FRCPA of the Children’s National Health System, Washington, DC discusses the treatment of adolescent and young adult (AYA) lymphoma patients, in particular those with high-grade lymphoma such as Burkitt lymphoma and diffuse large B-cell lymphoma (DLBCL), with Kieron Dunleavy, MD and Thomas Gross, MD, PhD from the National Cancer Institute, Bethesda, MD. The debate is on whether these patients should be treated with a pediatric-focused regimen or an adult-focused regimen. Dr Bollard points out that this is an area of unmet need and there is a lot that is not known about this population. The first question is if AYA patients with Burkitt lymphoma or DLBCL should be treated with the same regimen and if this is why kids do better. Dr Gross explains results with different types of treatment and he argues that they should be treated with the same regimen. They also discuss the issue of high-dose methotrexate. Dr Dunleavy first explains why kids do better with treatment, which he explains with their tumor biology and their tolerance of treatment. He also discusses the classification and staging system used for adult and pediatric patients. Further, they discuss the treatment of primary mediastinal large cell lymphoma (PMBL), including EPOCH-R and radiation. Dr Gross points out that the AYA population is not only complex from a biological point of view, but also from a social and behavioral point of view. Finally, the discuss next steps, such as novel therapies.
Recorded at the 2016 International Workshop on Non-Hodgkin Lymphoma (iwNHL) meeting held in San Diego, CA.