Brentuximab vedotin combined with risk-adapted chemoimmunotherapy for Hodgkin’s lymphoma in Chinese children: a single-center, nonrandomized controlled study

Classic Hodgkin lymphoma (cHL) has high curability following chemotherapy combined with radiation treatments, but an excess of short-term and long-term treatment-related morbidities remain a concern. The challenge associated with cHL treatment lie in significantly reducing the long-term toxicity of successful combination chemoradiotherapy while ensuring excellent survival rates. A prospective, non-randomized, risk-stratified phase II study was conducted on the clinicopathological data, treatment methods, and follow-up records of children who were initially diagnosed with cHL and completed treatment at our hospital from October 2022 to January 2026. The Kaplan‒Meier method was used to calculate survival rates. Sixty-one children with cHL were included (13 intermediate-risk; 48 high-risk). Fifty-four (88.5%) patients achieved a CMR upon completion of chemoimmunotherapy, with 83.6% of patients achieving rapid early response (RER), and the majority of patients (86.9%) avoided involved-field radiotherapy. Toxicities included grade 1 ~ 2 myelosuppression (8.2%), grade 2 mild peripheral neuropathy (two cases, 3.3%), and grade 2 allergic reaction to Bv (one case, 1.6%). Retreatment with conventional chemotherapy for relapsed patients remained effective. The event-free survival (EFS) for all patients in the group was 96.7%, and the overall survival (OS) reached 100%, with a median follow-up time of 24 months (range: 9–35 months). Among patients followed up for 12 months or longer (52 cases), the immune profiles demonstrated an IgG level of 19.2 ± 0.9 g/L, and an absolute total B-cell count of 190.9 ± 8.3cells/µL (both within the normal range). There were no deaths or losses to follow-up. The immunotherapy regimen with both Bv and rituximab along with risk-adapted chemotherapy demonstrates safety in Chinese pediatric patients with newly diagnosed cHL. Larger cohort studies are needed to validate these preliminary findings.