Treatment of children with relapsed and refractory classical Hodgkin’s lymphoma: the experience of two centers

Relevance. Relapses and refractory course (r/r) develop in 10 % of children and adolescents with a newly diagnosed classical Hodgkin lymphoma (cHL). The basis for successful treatment of r/r cHL is morpho-immunohistochemical diagnostics and positron emission tomography, as well as the inclusion of targeted and immune drugs in the treatment regimen. Russian experience of intercenter interaction in the treatment of r/r cHL is small, so each new study is significant from a scientific and practical standpoint.

The aim of the study is to present long-term results of r/r cHL treatment using targeted drugs, chemotherapy and autologous hematopoietic stem cell transplantation.

Materials and methods. From 2003 to 2023, 73 patients with r/r cHL were included in the study. The age of the patients ranged from 5.5 to 18.6 years (median – 14.5 years). Second-line therapy was carried out according to the following regimens: ICE (n = 23; 31.5 %), ViGePP (n = 15; 20.5 %), DHAP (n = 6; 8.2 %), IEP/ABVD (n = 6; 8.2 %); 7 (9.6 %) patients underwent a change in treatment regimen due to a poor response to the first 2 courses of therapy. Sixteen (21.9 %) patients were treated according to the ViGePP regimen with the addition of brentuximab vedotin (6 injections).

Results. The 10-year overall survival of patients was 76 ± 6 %, relapse-free survival (RFS) was 64 ± 6 %. When brentuximab vedotin was included in the therapy program, the RFS was higher – 83 ± 15.2 % (p = 0.09).

Conclusion. The results of a joint cooperative study of two Russian clinics for the treatment of r/r cHL are presented. The data obtained allow us to state the high efficiency of second-line therapy regimens with brentuximab vedotin and subsequent autologous stem cell transplantation.

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