Anti-Cd20 Monoclonal Antibody (Rituximab) for Therapy of Cd20-Positive Nodular Lymphocyte-Predominant Hodgkin Lymphoma in an 10-Year-Old Girl

Abstract

Biologic treatments including antibody-based therapies are still in early-phase development in Hodgkin lymphoma. The authors present the case of a 10-year-old girl with massive, solid, unilateral cervical, nodular lymphocyte-predominant Hodgkin lymphoma. Chemotherapy (doxorubicin, bleomycin, vinblastine, and dacarbazine [ABVD]) and radiotherapy were given, according to the Italian Association of Pediatric Hematology and Oncology (AIEOP) MH-96 study protocol, but the patient failed to enter complete remission. Soon after, 6 intravenous infusions of the chimeric anti-CD20 monoclonal antibody rituximab 375 mg/m2 were administered, resulting in complete remission. The patients is still in continuous complete remission for 2 years. Novel therapies, such as rituximab, may be useful for children with CD20+ nodular lymphocyte-predominant Hodgkin lymphoma. To the authors' knowledge, this is the first report of CD20+ nodular lymphocyte-predominant Hodgkin lymphoma treated with rituximab in children. Further controlled trials and long-term outcome studies are warranted to define its clinical application and to improve the care of patients.

Nodular lymphocyte predominant Hodgkin lymphoma in children and adolescents – a comprehensive review of biology, clinical course and treatment options

“…However, in childhood and adolescent nLPHL, except for one case report of the use of RTXB in a 10‐year‐old with refractory advanced stage nLPHL (Culić et al , ), there are no other published reports. As the emerging data from published adult literature on RTXB as first line and salvage therapy in nLPHL is encouraging, its use in childhood nLPHL could be considered as a new treatment option either alone or in combination with chemotherapy or radiotherapy, especially for patients with relapsed or advanced stage disease.…”

Recent Advances in the Pathobiology of Hodgkin's Lymphoma: Potential Impact on Diagnostic, Predictive, and Therapeutic Strategies

“…Since LP cells in NLPHL express CD20, the role of the anti-CD20 monoclonal antibody, rituximab (Rituxan), has been explored in NLPHL in the past few years, starting with a few cases studies such as that reported by Čulić et al [219] in which a pediatric patient refractory to ABVD plus radiation therapy achieved complete remission following rituximab infusion. Zojer et al reported an adult patient with NLPHL who responded to another anti-CD20 antibody, yttrium-90-labelled ibritumomab tiuxetan (Zevalin) [220].…”