A systematic review of treatments for paediatric patients with relapsed/refractory mature B-cell Non-Hodgkin lymphoma

A systematic literature review was conducted to evaluate the clinical effectiveness and safety of treatments for paediatric patients, up to the age of 18 years, with relapsed/refractory (R/R) mature B-cell non-Hodgkin lymphoma (NHL), including Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL) but excluding primary mediastinal B-cell lymphoma (PMBCL). A search of Medline, Embase and the Web of Science databases was conducted to identify any prospective study or case series published from January 1 st 2016 to 31 st December 2024. On-going clinical trial databases were also searched. Articles were included if they evaluated any single agent or combination of treatments in paediatric patients with relapsed/refractory NHL who had received at least one prior line of therapy. Four studies were identified, only one of which was a randomized controlled trial (RCT). No treatment appeared in more than one trial and therefore results from each trial could not be quantitatively pooled by meta-analysis. Differences in study design, baseline characteristics and inclusion and exclusion criteria made comparison of results difficult. There is a noticeable lack of RCTs evaluating treatments for paediatric patients with relapsed/refractory mature B-cell NHL making meaningful comparisons of effectiveness across trials rather difficult. This trend continues as all except one of the 9 on-going trials in this area are single arm studies. RCTs are required to enable better evaluation of the optimal treatment regimen for this group of patients