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Objectives <p>To assess the impact of adding rituximab on outcomes in children with aggressive mature B-non Hodgkin’s lymphoma (B-NHL) in resource-challenged settings.</p> Methods <p>This retrospective study was conducted at a tertiary care cancer center in India. Children aged &lt; 18 y with newly diagnosed advanced mature B-NHL between January 2004-June 2023 were included. Patients treated in December 2016 or after were included in the post-rituximab group and those treated prior were included in the pre-rituximab group. Clinical details were compiled from hospital records. Patients in the pre- and post-rituximab groups were matched using 1:1 propensity score matching to minimize baseline differences. The impact of rituximab on event-free survival (EFS) and overall survival (OS) was examined using multivariable Cox proportional hazards regression on the matched cohort.</p> Results <p>The cohort included 138 patients in the pre-rituximab and 82 in the post-rituximab groups of median age eight years. The 5-year EFS was 56.7% and 69.6% in the pre- and post-rituximab groups respectively and treatment-related mortality was similar in both groups (17.4% and 17.3% respectively; <i>p</i> = 0.952). Rituximab use predicted for superior EFS (aHR = 0.30; 95% CI: 0.14–0.67; <i>p</i> = 0.003) and OS (aHR = 0.29; 95% CI = 0.12–0.70; <i>p</i> = 0.006) following adjustment for baseline characteristics. In a 1:1 propensity score-matched cohort, patients in the post-rituximab group had superior 5-year EFS (HR = 0.20, <i>p</i> = 0.0014) and OS (HR = 0.27, <i>p</i> = 0.016).</p> Conclusions <p>The present data suggests that rituximab addition improves survival in children with aggressive advanced mature B-NHL, even in low-middle income country (LMIC) settings without an increase in treatment-related mortality.</p>

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Assessing the Impact of Rituximab on Treatment Outcomes in Pediatric Advanced Mature B-Non Hodgkin Lymphoma

  • 期刊论文

  • 发表日期：

    2026年3月4日

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  • Ekta Rahul,
  • Archana Sasi,
  • Shuvadeep Ganguly,
  • Vivek Kumar,
  • Deepam Pushpam,
  • Atul Batra,
  • Saumyaranjan Mallick,
  • Mehar Chand Sharma,
  • Rakesh Kumar,
  • Sameer Bakhshi

摘要

Objectives

To assess the impact of adding rituximab on outcomes in children with aggressive mature B-non Hodgkin’s lymphoma (B-NHL) in resource-challenged settings.

Methods

This retrospective study was conducted at a tertiary care cancer center in India. Children aged < 18 y with newly diagnosed advanced mature B-NHL between January 2004-June 2023 were included. Patients treated in December 2016 or after were included in the post-rituximab group and those treated prior were included in the pre-rituximab group. Clinical details were compiled from hospital records. Patients in the pre- and post-rituximab groups were matched using 1:1 propensity score matching to minimize baseline differences. The impact of rituximab on event-free survival (EFS) and overall survival (OS) was examined using multivariable Cox proportional hazards regression on the matched cohort.

Results

The cohort included 138 patients in the pre-rituximab and 82 in the post-rituximab groups of median age eight years. The 5-year EFS was 56.7% and 69.6% in the pre- and post-rituximab groups respectively and treatment-related mortality was similar in both groups (17.4% and 17.3% respectively; p = 0.952). Rituximab use predicted for superior EFS (aHR = 0.30; 95% CI: 0.14–0.67; p = 0.003) and OS (aHR = 0.29; 95% CI = 0.12–0.70; p = 0.006) following adjustment for baseline characteristics. In a 1:1 propensity score-matched cohort, patients in the post-rituximab group had superior 5-year EFS (HR = 0.20, p = 0.0014) and OS (HR = 0.27, p = 0.016).

Conclusions

The present data suggests that rituximab addition improves survival in children with aggressive advanced mature B-NHL, even in low-middle income country (LMIC) settings without an increase in treatment-related mortality.