Antibody therapies for lymphoma in children

Review question

The objective of this review was to assess the efficacy of the treatment of lymphoma in children with antibody therapy in terms of survival, relapse rates and response to treatment, compared with therapy not including antibody treatment. Furthermore, it aimed to evaluate the effects of antibody therapy on quality of life and side effects.

Background

Lymphomas are the third most common cancer of childhood. They are cancer of the lymphatic system, which is part of the immune system and protects the body from infection. They often present as painless masses, accompanied by signs and symptoms resulting from local compression, as well as other signs and symptoms, such as fever and weight loss. Cure rates are high, exceeding 80%, but over the past years a plateau has been reached. Furthermore, cure rates for recurrent disease are dramatically lower. The long term effects of chemotherapy (chemicals used to treat cancer) are of great concern. Therefore, new treatments must be developed. Antibodies are produced by our bodies to help fight infection. Treatment with antibodies (antibody therapy) is a successful new treatment option in adults with lymphoma. However, none of the therapeutic antibodies available for adults with cancer have been approved for treatment of paediatric lymphomas. Monoclonal antibodies are proteins that recognise specific proteins on the surface of our body's cells. This binding could be used as a therapy for cancer. Binding of the antibody could result in direct cell death, or could mark the cells that need to be cleared by our body using the immune system.

Search date

8 October 2014.

Study characteristics

We included only studies comparing the use of antibody therapy to the standard care in identical groups of children.

Study funding sources

We included no studies in our analysis.

Key results

We found no studies. The authors analysed 27 publications investigating the safety and tolerability of two antibody therapies, rituximab and brentuximab vedotin, in children with various types of lymphoma. These trials indicated that antibody therapy is safe to use in children and is well tolerated. Furthermore, there seems to be a positive effect on survival rates. To further evaluate the effects randomised controlled trials (clinical studies where people are randomly put into one of two or more treatment groups) must be performed.

Use of statistics

We performed no analyses.

Quality of the evidence

We found no studies.

Authors' conclusions: 

At this moment, it is not possible to draw evidence-based conclusions regarding clinical practice. Phase I and II studies show a positive effect of using antibody therapy in childhood lymphoma. Further research is needed to evaluate and implement antibody therapy for paediatric lymphoma.

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Background: 

Lymphomas are the third most common malignancy in childhood. Cure rates are high but have reached a plateau. Therefore new treatment modalities should be developed. Antibody therapy is a successful new treatment option in adult lymphoma. However, none of the therapeutic antibodies available for adults with cancer have been approved for treatment of paediatric lymphoma.

Objectives: 

To assess the efficacy of antibody therapy for childhood lymphoma in terms of survival, response and relapse rates, compared with therapy not including antibody treatment. To assess quality of life and the occurrence of adverse effects caused by antibody therapy treatment in children compared with therapy not including antibody treatment.

Search strategy: 

We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2014, Issue 10), MEDLINE in PubMed (from 1945 to October 2014), EMBASE in EMBASE.com (from 1980 to October 2014) and reference lists of relevant articles. Furthermore, we searched conference proceedings abstracts of SIOP, ASCO and ASH for studies from 2009 to 2013), and the World Health Organization (WHO) ICTRP portal and ClinicalTrials.gov for ongoing trials.

Selection criteria: 

Randomised controlled trials and controlled clinical trials comparing conventional therapy with antibody therapy in children with lymphoma.

Data collection and analysis: 

Two authors independently performed the study selection.

Main results: 

We found no studies meeting the inclusion criteria of the review.

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