The Landscape of Adolescent and Young Adult (AYA) Survivorship: A Case Report and Narrative Review of Legislation, Research, and Gaps in AYA Survivorship in the US.

Hematologic malignancies are the most common cancers of childhood, comprising 28% of pediatric cancers. Decades of therapeutic innovation have led to survival rates of greater than 90% for this condition. However, high-dose chemotherapy can carry significant immediate and delayed toxicities. Adolescents and young adults (AYA) from ages 15 to 39 are particularly vulnerable to treatment-related toxicities. This is amplified by gaps in care provision for adolescent patients and fragmentation within the U.S. insurance system. This review explores contributors to this vulnerable period for AYA patients and major milestones for the AYA survivorship movement. Our review also highlights a case vignette of a leukemia AYA survivor who faced a near-lethal complication of his chemotherapy a decade after remission. Our review supports ongoing research on AYA cancer survivorship and efforts to standardize the management of this uniquely underserved population.