Targeted immunotherapy in the treatment of childhood and adolescent mature B-cell lymphoma.

Abstract

Mature B-cell non-Hodgkin lymphomas (B-NHLs) comprise approximately 40% to 60% of all NHLs among children, adolescents, and young adults. Although overall survival with mature B-NHL approaches 90% in children younger than 15 years and 70% to 80% in adolescents and young adults, it is achieved with the use of intense therapeutic regimens, many of which lead to long-term effects that last for years after the patient's initial diagnosis and treatment. Chronic health issues, poor performance outcomes, impaired quality of life, and decreased fertility have all been associated with mature B-NHL therapy. As the role of targeted therapy in this population is elucidated, data continue to show that it can be incorporated safely into chemotherapy backbones, allowing a decrease in cytotoxic chemotherapy doses. These trends support ongoing efforts to find innovative combinatorial strategies that integrate new cell surface targets and use new classes of drugs, such as monoclonal antibodies, antibody-drug conjugates, checkpoint inhibitors, T-cell and natural killer-cell engagers, and chimeric antigen receptor T-cell therapy.