Application of anti-programmed cell death protein 1 antibody in children with refractory or relapsed Hodgkin lymphoma
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3760/cma.j.cn112140-20211014-00869
   		
        
        	
        		- VernacularTitle:程序性死亡受体1抗体在儿童难治或复发霍奇金淋巴瘤中的应用探索
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Ying LI
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Yanlong DUAN
			        		
			        		;
		        		
		        		
		        		
			        		Shuang HUANG
			        		
			        		;
		        		
		        		
		        		
			        		Meng ZHANG
			        		
			        		;
		        		
		        		
		        		
			        		Ling JIN
			        		
			        		;
		        		
		        		
		        		
			        		Yonghong ZHANG
			        		
			        		;
		        		
		        		
		        		
			        		Xiaoling WANG
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. 国家儿童医学中心 首都医科大学附属北京儿童医院药学部,北京100045
			        		
		        		
	        		
        		 
        	
        	
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Lymphoma;
			        		
			        		
			        		
				        		Recurrence;
			        		
			        		
			        		
				        		Child
			        		
			        		
	        			
        			
        		
 
        	
            
            
            	- From:
	            		
	            			Chinese Journal of Pediatrics
	            		
	            		 2022;60(6):573-577
	            	
            	
 
            
            
            	- CountryChina
 
            
            
            	- Language:Chinese
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	Objective:To explore the efficacy of anti-programmed cell death protein 1 (PD-1) antibody for children with refractory or relapsed Hodgkin lymphoma.Methods:Clinical data including short-term efficacy, long-term efficacy and adverse reaction of Hodgkin lymphoma children treated with anti-PD-1 antibody in Beijing Children′s Hospital, Capital Medical University from December 2017 to June 2021 were analyzed retrospectively. Efficacy was evaluated as complete remission (CR), partial remission (PR), stable disease (SD), progressed disease (PD) and no response.Results:A total of 6 cases were included, including 5 males and 1 female. The age at the start of anti-PD-1 antibody treatment was 11.6 (10.2, 13.3) years, including 3 cases of mixed cellularity type, 2 cases of nodular sclerosis type, and 1 case of nodular lymphocyte-predominant type. There were 4 cases of stage Ⅳ and 2 cases of stage Ⅲ. All cases were assigned to the high-risk group, and 5 cases had B symptoms, all cases were refractory or relapsed Hodgkin lymphoma before the start of anti-PD-1 antibody treatment. Early evaluation showed that within 12 weeks of the treatment, 3 cases achieved PR and 3 cases achieved SD, while late evaluation showed that after 16 weeks of the treatment, 5 cases achieved CR and 1 case achieved PR. None of the children progressed during treatment. The follow-up time was 27 (21,41) months. Among all cases, 5 cases had event-free survival and sustained remission, 1 case had fever about 4 weeks after the drug withdrawal, finally he was confirmed to be transformed to B cell lymphoma between diffuse B cells and classic Hodgkin lymphoma. All the patients were well tolerated with anti-PD-1 antibody therapy. No adverse reactions such as high fever, chills, rash, etc. were observed during infusion. None of the patients were delayed, dose reduction or withdrawal due to adverse reactions. Two cases had reactive skin vascular hyperplasia during the treatment, without pain or itching, and they recovered on their own after stopping anti-PD-1 antibody therapy without other special treatment.Conclusion:Anti-PD-1 monoclonal antibody for children with refractory or relapsed Hodgkin lymphoma have good efficacy and tolerable side effects.