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Preparing For Survivorship After Lymphoma Treatment in AYA PatientsPreparing For Survivorship After Lymphoma Treatment in AYA Patients

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Dr. Kara Kelly discusses specific long-term health considerations that AYA survivors of lymphoma should be aware of to best prepare for survivorship.

The treatment of adolescent and young adult (AYA) patients with lymphoma — a type of blood cancer — varies from the therapeutic plans used in pediatric or adult patients, requiring unique considerations for this underserved patient population, according to Dr. Kara Kelly, a pediatric oncologist.

Particularly, there are specific long-term health considerations that AYA survivors of lymphoma should be aware of in order to best prepare for survivorship after treatment. In order to further discuss this topic, Kelly sat down for an interview with CURE.

She is also the chair of the Department of Pediatric Oncology, as well as the Waldemar J. Kaminski Endowed Chair of Pediatrics, at the Roswell Park Comprehensive Cancer Center, located in Buffalo, New York.

Transcript:

Fortunately, most of the lymphoma types we see in the adolescent and young adult age group are very treatable and associated with high survival rates and good response to therapy. These patients are likely to be cured, and being fairly young, they have a very long life ahead of them. However, with this, we unfortunately do see the emergence of late toxicities from therapy, especially from the more conventional treatments that have been part of our therapeutic options.

For example, in Hodgkin lymphoma, up until recently, the standard had been to combine chemotherapy with radiation treatment. With this approach, our long-term survivors can experience higher rates of developing second cancers, like breast cancer or thyroid cancer, because of the areas where the radiation fields were directed. High cumulative doses of chemotherapy, particularly doxorubicin, can increase the risk of long-term cardiovascular complications like the early development of congestive heart failure or a higher risk of strokes and valve problems.

Additionally, some chemotherapy agents are associated with an impact on fertility. Our female survivors are at higher risk for developing premature menopause, while male survivors are at risk for not being able to produce sperm anymore. Therefore, it is very important that our survivors have an oncofertility consultation at the time of diagnosis, so they know what their options are, especially regarding the cryopreservation of eggs or sperm, to give them more options after their therapy is complete.

Transcript has been edited for clarity and conciseness.

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