Gao Huixia, Li Ying, Li Nan, Huang Shuang, Zhang Meng, Zhou Chunju, Zhang Ningning, Zhang Yiming, Yang Jing, Jin Ling, Wang Xiaoling, Peng Yaguang, Wang Tianyoug, Duan Yanlong Corresponding author: Duan Yanlong, Email: duanyanlong@hotmail.com
Abstract: Objective To explore the safety and clinical efficacy of Brentuximab Vedotin (BV) combined with Rituximab (R) and attenuated chemotherapy in the treatment of children with classic Hodgkin Lymphoma (cHL). Methods 40 children with newly diagnosed with intermediate-risk or high-risk cHL were enrolled from October 2022 to June 2024, who received the detection of biopsy pathological morphology and immunohistochemistry. Risk-adapted combination of immune-targeted combined with attenuated chemotherapy was given based on pre-treatment risk and early treatment response. The safety and clinical efficacy were summarized. Results 40 cHL children included 25 males and 15 females, with a median age of 12 years. 22 cases (55.0%) had bulky lymph nodes. 30 cases (75%) were in stage III-IV according to the Ann Arbor staging system. There were 5 intermediate-risk and 34 high-risk patients. 36 cases (90.0%) achieved Complete Metabolism Response (CMR) after 2 courses of chemotherapy. The CMR rates were 100% in middle-risk group and 88.2% in high-risk group, respectively. Five patients (12.5%) required radiotherapy. Toxicities included grade I~II myelosuppression, infusion reaction and mild peripheral neuropathy without dose-limiting toxicity. All the 40 patients were in continuous remission, and there were no deaths or lost to follow-up. Median follow-up was 6 months (3,13 months). Conclusions BV+R combined with attenuated chemotherapy and risk-adapted combination for cHL in children is effective and well tolerated, and significantly reduce radiation rate. Larger cohorts and longer follow-up will be required to confirm these preliminary findings.
Key words: Brentuximab Vedotin; Rituximab; Hodgkin's lymphoma; Children; Clinical research
Huixia Gao, Yanlong Duan