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

## TL;DR

This study examines the treatment and survival outcomes of adolescents and young adults with diffuse large B-cell lymphoma in Peru, finding that standard treatments yield good results but relapsed cases have poor outcomes.

## Contribution

The study provides real-world evidence on DLBCL outcomes in AYAs from a low-to-middle-income country context.

## Key findings

- AYAs treated with R-CHOP had 5-year overall survival of 77% and progression-free survival of 66%.
- Relapsed/refractory AYAs had a 3-year survival rate of 36%, highlighting poor outcomes for this subgroup.
- Most patients with relapsed/refractory disease received second-line treatment, but few underwent autologous transplantation.

## 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 (n = 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.