Abstract
OBJECTIVE: To conduct a systematic review and meta-analysis evaluating the efficacy and safety of rituximab combined with chemotherapy for the treatment of mature B-cell non-Hodgkin's lymphoma (NHL) in children and adolescents. METHODS: A comprehensive search of PubMed, Embase, the Cochrane Library, and Web of Science was performed to identify relevant studies published up to October 2024. Eligible studies included those involving patients aged 0-15 years diagnosed with mature B-cell NHL. Data were extracted on event-free survival (EFS), overall survival (OS), complete remission rate (CRR), adverse events, immune reconstitution (IgG levels), and recurrence rates. Meta-analyses were conducted using RevMan 5.0. RESULTS: A total of 11 studies comprising 1,522 participants were included. The addition of rituximab to chemotherapy significantly improved EFS (hazard ratio [HR] = 0.40, 95% confidence interval [CI]: 0.36-0.45, P < 0.05) and OS (HR = 0.38, 95% CI: 0.34-0.42, P < 0.05). CRR was also significantly higher in the rituximab group (odds ratio [OR] = 2.72, 95% CI: 1.76-4.21, P < 0.05). However, a higher incidence of adverse effects was observed (OR = OR= 1.92, 95% CI: 1.25-2.94, P < 0.05). There were no significant differences in recurrence rate or IgG levels between groups. CONCLUSION: The addition of rituximab to chemotherapy significantly improved EFS, OS, and CRR in children and adolescents with mature B-cell NHL. Despite an increased risk of toxicity, the survival and remission benefits support the use of rituximab in this population.