The incidence of non-Hodgkin lymphoma has increased in all age groups through to age 30 years, and in 20- to 29-year-olds, the increase has been dramatic, averaging 4-19% per year over 25 years. Follic-ular (nodular) and mantle cell lymphoma, virtually nonexistent before age 15 years, increases to represent 11% of all non-Hodgkin lymphomas among 25- to 29-year-olds. Males are far more likely than females to develop non-Hodgkin lymphoma, especially Burkitt lymphoma. For 15- to 29-year-olds with either Burkitt or non-Burkitt non-Hodgkin lymphoma, survival improvement has significantly lagged behind that achieved in children and older adults with the same diseases, a deficit that can not be attributed solely to the HIV era.

The biology, prognosis and best treatment regimen for adolescents and young adults with non-Hodgkin lymphoma is still currently largely unknown. Few comparative studies have been performed to determine if the genetics and/or biology of adolescent and young adult non-Hodgkin lymphoma are similar to those of childhood or adult non-Hodgkin lymphoma, or whether it is a distinct biological entity. The pediatric approach may be more beneficial for certain subtypes of adolescent and young adult non-Hodgkin lymphoma and with other subtypes there is little data to support either pediatric or adult approaches as being superior. Further research and collaboration with pedi-

atric and adult oncology cooperative groups is required to improve our understanding of the biology and best treatment approach for this subset of adolescents and young adults with non-Hodgkin lymphoma.

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