Abstract
To describe a rare case of primary refractory Hodgkin lymphoma nodular sclerosis syncytial variant in a child and review immunotherapy in relapsed/refractory Hodgkin lymphoma. We described the treatment course of a child with primary refractory classic Hodgkin lymphoma and discussed different options for salvage therapy, with an emphasis on immunotherapy. We searched PubMed for all published clinical trials investigating immunotherapy in classic Hodgkin lymphoma written in English until 31 June, 2023. The reference list of each identified paper was searched for additional publications. Our patient was salvaged with anti-programmed cell death 1 (PD-1) antibody therapy followed by high-dose chemotherapy with autologous stem cell rescue. Radiotherapy was avoided. We identified five one-armed phase II trials investigating anti-PD-1 therapy in first relapse/refractory disease in a total of 254 patients aged 9-71 years, of which one included 31 children. The complete remission rate before high-dose chemotherapy was 59%-95% overall and 67%-89% among those with refractory disease. Although it remains to be proven in randomised trials, anti-PD-1 therapy may provide higher complete response rates than traditional chemotherapy. Anti-PD-1 therapy has the potential to increase the chance of cure while decreasing the risk of late effects from chemotherapy and radiotherapy.
Overview
- The study focuses on a rare case of primary refractory Hodgkin lymphoma nodular sclerosis syncytial variant in a child and reviews immunotherapy in relapsed/refractory Hodgkin lymphoma. The hypothesis being tested is the effectiveness of immunotherapy in salvaging patients with refractory Hodgkin lymphoma. The methodology used for the experiment includes a case report of a child with primary refractory classic Hodgkin lymphoma and a review of clinical trials investigating immunotherapy in classic Hodgkin lymphoma. The primary objective of the study is to evaluate the effectiveness of immunotherapy in salvaging patients with refractory Hodgkin lymphoma and compare it to traditional chemotherapy. The study aims to answer the question of whether immunotherapy can provide higher complete response rates than traditional chemotherapy and decrease the risk of late effects from chemotherapy and radiotherapy.
Comparative Analysis & Findings
- The study compares the outcomes observed under different experimental conditions or interventions, specifically the effectiveness of immunotherapy versus traditional chemotherapy in salvaging patients with refractory Hodgkin lymphoma. The results of the study show that anti-programmed cell death 1 (PD-1) therapy may provide higher complete response rates than traditional chemotherapy. The study also highlights that immunotherapy has the potential to increase the chance of cure while decreasing the risk of late effects from chemotherapy and radiotherapy.
Implications and Future Directions
- The study's findings have significant implications for the field of research and clinical practice, as they suggest that immunotherapy may be a more effective and less toxic treatment option for patients with refractory Hodgkin lymphoma. However, the study's limitations include the small sample size and the need for randomized trials to confirm the findings. Future research directions could include larger randomized trials to further evaluate the effectiveness of immunotherapy in salvaging patients with refractory Hodgkin lymphoma and exploring the potential benefits and risks of different immunotherapy options.