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Commentary: Addition of rituximab improves survival in children with B-cell lymphomas

Addition of rituximab to standard chemotherapy for children with high grade, B-cell cancer prolongs event-free survival and overall survival according to the results of a new study.

Researchers from the European intergroup for childhood non-Hodgkin lymphoma and oncology group, recently published data from a Phase III, international, randomised clinical trial in patients under 18 years of age who had a high-risk, mature B-cell lymphoma (stage III) or acute leukaemia. The trial compared the addition of six doses of rituximab to standard lymphoma malins B (LMB) chemotherapy against LMB therapy alone in 328 patients.

The primary endpoint was event-free survival which was defined in several ways including relapse, progressive disease, second cancer or death from any cause. After a median follow-up of 39.9 months, there were 10 events in the rituximab group compared to 28 in the LMB group and the event-free survival rate was 93.9% in patients given rituximab compared to 82.3% in the LMB group. In total, eight patients treated with rituximab died compared to 20 in the LMB group.

However, although more effective, treatment with rituximab resulted in 37.7% of patients experiencing serious adverse effects, mainly febrile neutropenia, compared with 32.7% in the LMB group.

Minard-Colin V et al. Rituximab for high-risk, mature B-cell non-Hodgkin’s lymphoma in children. N Eng J Med 2020;382:2207-19.

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