Background: Prior research reveals AYA experience psychological distress living with future uncertainty regarding their cancer. However, coping with death anxiety and its effect on psychological well-being and QOL of AYA hematologic survivors has not been described. Methods: AYA patients (15-40 years at diagnosis) of acute leukemia, aggressive non-Hodgkin lymphoma, and Hodgkin lymphoma undergoing curative intent therapy (on-treatment cohort) or 2 year completion of therapy and in remission (early survivor cohort) completed following measures: depression (CES-D), state anxiety (STAI-S), PTSD (PCL-C), QOL (FACIT-G). Semi-structured interviews evaluated death anxiety: pain-suffering; loneliness, unknown. Results: 62 AYA subjects (26 on-treatment, 36 early survivors) were interviewed. For total population: median age at diagnosis 26y (15-39); 64% male; 59% Ca; 79% college/postgrad educ; 41% income < $75,000yr; 52% and 48% lymphoma or leukemia dx, respectively. Overall, 67% AYA acknowledged death anxiety. Of these, 45% of AYA reported fear of pain-suffering; 26% reported fear of loneliness; 41% reported fear of unknown. AYA with death anxiety had higher STAI-S anxiety (39 ± 9.9 v 30.7 ± 9.7, p = .01) and CES-D depression (23 ± 12.3 v 12.5 ± 8.3, p < .00). Also, AYA with death anxiety had poorer FACT-G QOL (80.5 ± 16 v 86 ± 14.3, p = .04). Fear of suffering was associated with moderate illness-related PTSD symptoms (34 ± 11.3 v 27.5 ± 10.4, p < .00). AYA with fear of loneliness had greater CES-D (19 ± 13.3 v 10.2 ± 9.4, p = .02). On-treatment AYA were more likely to acknowledge death anxiety (52% v 43%, p = .03) than early survivor cohort. Conclusions: AYAs with hematologic malignancies report fears of dying which negatively impacting QOL. Tailored age-specific psychological interventions designed to address survivor fears are needed.