Targeted therapies and immunotherapy in the treatment of pediatric Hodgkin Lymphoma: A literature review on advances and challenges

Abstract

Introduction: Hodgkin's lymphoma is a relatively rare lymphoproliferative neoplasm in children, but common among adolescents and young adults, representing about 6% of pediatric cancer cases in Brazil. Standard treatment with chemotherapy and radiotherapy has a high cure rate, but is associated with significant long-term adverse effects. In recent years, targeted therapies and immunotherapies, such as monoclonal antibodies and immune checkpoint inhibitors, have shown promise for refractory or relapsed pediatric patients. Methodology: The integrative review included studies published between 2020 and 2024, selected from databases such as PubMed, SciELO, and LILACS, using terms such as "pediatric Hodgkin lymphoma" and "immunotherapy". Original studies, systematic reviews, and case reports addressing the use of targeted therapies and immunotherapies in pediatric patients were considered, excluding publications prior to 2020, articles without full text, and non-relevant studies. Results: Targeted therapies, such as brentuximab vedotin, and immunotherapies, including the use of CAR-T cells, have been shown to be effective in the treatment of pediatric Hodgkin lymphoma, with reduced toxicity and a higher response rate in refractory cases. The studies highlight the importance of personalization of treatment, long-term monitoring, and equitable access to innovative therapies, especially in developing countries like Brazil. Conclusions: Targeted therapies and immunotherapies represent significant advances in the treatment of pediatric Hodgkin lymphoma, but their implementation faces challenges related to cost, accessibility, and the need for further studies on long-term effects. A coordinated effort is essential to ensure equitable access and safe use of these therapies.