古典霍奇金淋巴瘤（cHL）是最常见的儿科淋巴瘤。大约有10%的患者会发展成难治性或复发性疾病。这些患者接受强化化疗后，进行放疗或高剂量化疗和自体干细胞再输注以巩固治疗。尽管这种治疗是有效的，但其副作用包括严重的长期不良反应，如生育能力降低和二次癌症风险增加。最近，利用免疫检查点抑制剂尼伐普利（以PD-1为靶点）和抗CD30抗体药物结合物贝伐单抗（BV）+/-苯达莫司汀诱导缓解的有希望结果已经发表。在这里，我们描述了一组由10名复发和难治性儿科cHL患者组成的队列，他们接受了尼伐普利+BV+/-苯达莫司汀治疗，以在标准治疗前诱导缓解。所有患者在巩固治疗前都达到了完全缓解，经过治疗结束后中位随访时间为25个月（范围：12至42个月），他们仍然处于完全缓解状态。仅仅出现了一个由于尼伐普利+BV引起的CTCAE 3级或更高的不良事件。基于这些结果，我们得出结论，尼伐普利+BV+/-苯达莫司汀的免疫治疗是一种在标准巩固治疗前诱导缓解的有效和安全的治疗方法。我们提议进一步评估这种治疗，以研究潜在的长期毒性和降低巩固治疗强度的可能性。版权所有 © 2023 Greve, Beishuizen, Hagleitner, Loeffen, Veening, Boes, Peperzak, Diez and Meyer-Wentrup.

Classical Hodgkin lymphoma (cHL) is the most common pediatric lymphoma. Approximately 10% of patients develop refractory or recurrent disease. These patients are treated with intensive chemotherapy followed by consolidation with radiotherapy or high-dose chemotherapy and autologous stem cell reinfusion. Although this treatment is effective, it comes at the cost of severe long-term adverse events, such as reduced fertility and an increased risk of secondary cancers. Recently, promising results of inducing remission with the immune checkpoint inhibitor nivolumab (targeting PD-1) and the anti-CD30 antibody-drug conjugate Brentuximab vedotin (BV) +/- bendamustine were published.Here we describe a cohort of 10 relapsed and refractory pediatric cHL patients treated with nivolumab + BV +/- bendamustine to induce remission prior to consolidation with standard treatment.All patients achieved complete remission prior to consolidation treatment and are in ongoing complete remission with a median follow-up of 25 months (range: 12 to 42 months) after end-of-treatment. Only one adverse event of CTCAE grade 3 or higher due to nivolumab + BV was identified. Based on these results we conclude that immunotherapy with nivolumab + BV +/- bendamustine is an effective and safe treatment to induce remission in pediatric R/R cHL patients prior to standard consolidation treatment. We propose to evaluate this treatment further to study putative long-term toxicity and the possibility to reduce the intensity of consolidation treatment.Copyright © 2023 Greve, Beishuizen, Hagleitner, Loeffen, Veening, Boes, Peperzak, Diez and Meyer-Wentrup.