At what age is lymphoblastic lymphoma, a type of non-Hodgkin lymphoma (NHL), most commonly diagnosed?

Lymphoblastic Lymphoma: Age Distribution

Lymphoblastic lymphoma predominantly affects children and adolescents, with the majority of cases occurring in patients aged 10-30 years, and a median age at diagnosis in the teens to early twenties. 1, 2

Age-Specific Epidemiology

• Lymphoblastic lymphoma (LBL) accounts for 25-35% of all non-Hodgkin lymphomas in children and adolescents, making it the second most common NHL subtype in this age group 3, 4

• The disease occurs more commonly in children than in adults, with a marked male predominance 1

• Patients typically present in their teens to twenties, with most cases diagnosed during adolescence and young adulthood 1

• Within the adolescent and young adult (AYA) population aged 15-39 years, lymphoblastic lymphoma represents one of the most common aggressive lymphoma subtypes 2

Lineage-Specific Age Patterns

• T-lymphoblastic lymphoma (T-LBL) comprises 70-80% of all LBL cases and shows a strong predilection for younger patients, particularly adolescent males 3, 4

• Precursor B-lymphoblastic lymphoma (pB-LBL) accounts for 20-25% of cases and is less common overall 4

• T-LBL patients compared to B-LBL patients tend to be younger, typically presenting in their teens with mediastinal masses 1

Clinical Context and Presentation

• Adolescent and young adult males in their teens to twenties typically present with lymphadenopathy in cervical, supraclavicular, and axillary regions, or with an anterior mediastinal mass 1

• The mediastinal mass is frequently bulky and associated with pleural effusions, superior vena cava syndrome, tracheal obstruction, and pericardial effusions 1

• Most patients present with advanced disease, B symptoms, and elevated serum LDH levels 1

Important Clinical Distinction

• Unlike acute lymphoblastic leukemia (ALL), which has a median age at diagnosis of 13-17 years and represents 75-80% of acute leukemias in children, LBL presents as a mass lesion with <25% bone marrow blasts 5, 6

• While 80% of precursor B-cell neoplasms present as acute leukemias with bone marrow involvement, only a small proportion present as lymphoblastic lymphoma 1

Prognosis by Age

• Event-free and overall survival for pediatric LBL patients now exceeds 80% with current ALL-type chemotherapy regimens 3, 4

• Disease-free survival ranges from 73-90% in children compared to 45-72% in adults, demonstrating the age-dependent nature of outcomes 1

• Outcomes for relapsed or refractory disease remain dismal across all age groups, making upfront cure critical 4