Immunotherapy in Pediatric Relapsed or Refractory Lymphomas: A Case Series

Lymphomas are the third most frequent malignant neoplasm in pediatrics. Although polychemotherapy, with or without radiotherapy, is the first-line treatment, relapsed or refractory patients still represent a major challenge, with no established therapeutic consensus. In this context, immunotherapy has emerged as a promising strategy, with growing evidence of its efficacy in adults but limited data in pediatric patients. We report three male patients, aged 13 to 16 years of age, diagnosed with advanced-stage HL and T/NK-cell NHL, all refractory to multiple prior lines of treatment. The use of checkpoint inhibitors enabled disease rescue in two of the three cases, both achieving complete remission followed by consolidation with allogeneic hematopoietic stem cell transplantation. Immunotherapy demonstrated potential in selected pediatric cases of refractory lymphomas, allowing remission and subsequent hematopoietic stem cell transplantation in two patients. Despite the inherent limitations of a small case series, our findings contribute to real-world experience with immunotherapy in the pediatric setting and reinforce its emerging role in the management of these challenging clinical scenarios.