Evaluating chemoimmunotherapy for children with aggressive B-cell lymphoma

This study evaluated the effectiveness of chemoimmunotherapy in children and adolescents with aggressive B-cell non-Hodgkin’s lymphoma (NHL). This study concluded that combined chemoimmunotherapy is highly effective in these young patients.

B-cell NHL is one of the most common types of lymphoma in children and adolescents. Chemoimmunotherapy is the typical first-line treatment for patients with aggressive NHL. This type of treatment combines chemotherapy with immunotherapy.

For adult patients, the most commonly used regimens contain an immunotherapy drug called rituximab (Rituxan). Rituximab is a monoclonal antibody. This type of treatment targets cancer cells and blocks their growth. This leads to cancer cell death. How well rituximab works in combination with chemotherapy for treating B-cell NHL in children remains under investigation.

This study had 231 children with aggressive B-cell lymphoma. Most of these patients had Burkitt lymphoma (76.7%; BL) or diffuse large B-cell lymphoma (14%; DLBCL). 6% of patients had primary mediastinal large B-cell lymphoma (PMBCL). 68% of patients had advanced (stage 3 or 4) disease and 32% of patients had early-stage (stage 1 or 2) disease. Patients were treated with rituximab combined with chemotherapy. A total of 6 courses of treatment were given. Patients were followed-up for an average of 46 months.

Overall, 92.2% of all patients had a complete disappearance of all signs of cancer. For patients with early-stage NHL, this rate was 100%. For patients with advanced-stage NHL, this rate was 91.4%. At follow-up, 98.5% of patients with early-stage NHL were still alive. For patients with advanced-stage NHL, this rate was 82.7-90.9%.

At 43 months, 91% of all patients were still alive with no signs of cancer. By lymphoma subtype, this rate was 100% for patients with DLBCL, 92% for patients with PMBCL, and 89.9% for patients with BL.

30 patients had cancer present in the brain or spinal cord. At 3 years, 84% of these patients were still alive without tumor growth or spread.

This study concluded that chemoimmunotherapy with rituximab is highly effective in children and adolescents with aggressive B-cell NHL.

This study involved Russian children with aggressive B-cell lymphoma. Therefore, these results may not be applicable to all patients. The role of rituximab in the treatment of children and adolescents remains under investigation.