Anaplastic large cell lymphoma natural history, complications and prognosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Anaplastic large cell lymphoma}} | {{Anaplastic large cell lymphoma}} | ||
{{CMG}} | {{CMG}}; {{AE}} {{AS}}, {{kakbar}}; {{GRR}} {{Nat}} | ||
==Overview== | |||
The ALK-positive anaplastic large cell lymphoma is associated with the most favorable prognosis. ALK-positive anaplastic large cell lymphoma is associated with a 5 year survival rate of 70-80%. ALK-positive anaplastic large cell lymphoma is associated with a 5 year survival rate of 30-40%. | |||
===Natural History=== | |||
*If left untreated, patients with anaplastic large cell lymphoma may progress to develop [[anemia]], [[intestinal obstruction]], and [[Immunosuppression|immuno-suppression]] thus causing infection. | |||
===Complications=== | |||
*Common complications of anaplastic large cell lymphoma include: | |||
**Organ failure due [[metastasis]] | |||
**Immuno-suppression thus causing infection | |||
**[[CNS]] involvement causing: | |||
***[[Meningitis]] | |||
***Visual disturbance | |||
***Facial numbness | |||
**Anemia due to bleeding | |||
**Stroke due to vascular occlusion from leukemic cells | |||
==Prognosis== | ==Prognosis== | ||
Those with ALK positivity have a better [[prognosis]]. | *Those with ALK positivity have a better [[prognosis]]. <ref name="pmid29323068">{{cite journal| author=Agrawal K, Shet T, Sridhar E, Dhende S, Sengar M, Arora B et al.| title=Story of survival in anaplastic large cell lymphoma - sometimes more than the anaplastic lymphoma kinase status: An evaluation of pathologic prognostic factors in 102 cases. | journal=Indian J Pathol Microbiol | year= 2017 | volume= 60 | issue= 4 | pages= 533-540 | pmid=29323068 | doi=10.4103/IJPM.IJPM_778_15 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29323068 }} </ref> | ||
* Overall better prognosis than other | * ALK-negative anaplastic large cell lymphomas represent other [[T cell|T-cell]] lymphomas in a final common pathway of disease progression. | ||
* Overall better prognosis than other aggressive lymphomas. | |||
* ALK-positive anaplastic large cell lymphoma is associated with a 5 year survival rate of 70-80%. | |||
* ALK-positive anaplastic large cell lymphoma is associated with a 5 year survival rate of 30-40%. | |||
* The '''I'''nternational '''P'''rognostic '''I'''index (IPI) is used to estimate the prognosis of patients. | |||
* The IPI takes into account 5 variables: | |||
:* Patient's age (>60 years) | |||
:* Elevated serum [[lactate dehydrogenase]] ([[LDH]]) | |||
:* Eastern Cooperative Oncology Group (ECOG) performance status | |||
:* Ann Arbor clinical stage III or IV | |||
:* Number of involved extra nodal sites > 1 | |||
* If any of this criteria is met, one point is awarded for the IPI. The interpretation of the total score is as follows: | |||
:* 0 to 1: Low risk | |||
:* 2: Low-intermediate risk | |||
:* 3: High-intermediate risk | |||
:* 4 to 5: High risk | |||
* According to the International Peripheral T cell Lymphoma Project, the estimated 5-years survival for each of the IPI stages are as follows:<ref>{{cite web|url=http://www.bloodjournal.org/content/111/12/5496.abstract?sso-checked=true|title=ALK− anaplastic large-cell lymphoma is clinically and immunophenotypically different from both ALK+ ALCL and peripheral T-cell lymphoma, not otherwise specified: report from the International Peripheral T-Cell Lymphoma Project}}</ref> | |||
:* Low risk (IPI 0-1): 90% | |||
* | :* Low-intermediate risk (IPI 2): 68% | ||
* | :* High-intermediate risk (IPI 3): 23% | ||
* | :* High risk (IPI 4-5): 33% | ||
* However, more recently, the International peripheral T-cell lymphoma Project score (IPTCLP) has demonstrated to be the most accurate score to predict overall survival in patients.<ref>{{cite web|url=http://annonc.oxfordjournals.org/content/early/2010/07/14/annonc.mdq359.full.pdf+html|title=Comparison of four prognostic scores in peripheral T-cell lymphoma}}</ref> This score includes: | |||
:* Age | |||
:* Eastern Cooperative Oncology Group (ECOG) performance status | |||
:* Platelet count | |||
* | |||
However, recently, the International peripheral T-cell lymphoma Project score (IPTCLP) has demonstrated to be the most accurate score to predict overall survival in patients. <ref>{{cite web|url=http://annonc.oxfordjournals.org/content/early/2010/07/14/annonc.mdq359.full.pdf+html|title=Comparison of four prognostic scores in peripheral T-cell lymphoma}}</ref> | |||
This score includes: | |||
*Age | |||
*Eastern Cooperative Oncology Group (ECOG) performance status | |||
*Platelet count | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:needs content]] | |||
[[Category:Hematology]] | [[Category:Hematology]] | ||
[[Category:Types of cancer]] | [[Category:Types of cancer]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | |||
[[Category:Medicine]] | |||
[[Category:Hematology]] | |||
[[Category:Immunology]] |
Latest revision as of 12:43, 11 April 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2], Kamal Akbar, M.D.[3]; Grammar Reviewer: Natalie Harpenau, B.S.[4]
Overview
The ALK-positive anaplastic large cell lymphoma is associated with the most favorable prognosis. ALK-positive anaplastic large cell lymphoma is associated with a 5 year survival rate of 70-80%. ALK-positive anaplastic large cell lymphoma is associated with a 5 year survival rate of 30-40%.
Natural History
- If left untreated, patients with anaplastic large cell lymphoma may progress to develop anemia, intestinal obstruction, and immuno-suppression thus causing infection.
Complications
- Common complications of anaplastic large cell lymphoma include:
- Organ failure due metastasis
- Immuno-suppression thus causing infection
- CNS involvement causing:
- Meningitis
- Visual disturbance
- Facial numbness
- Anemia due to bleeding
- Stroke due to vascular occlusion from leukemic cells
Prognosis
- Those with ALK positivity have a better prognosis. [1]
- ALK-negative anaplastic large cell lymphomas represent other T-cell lymphomas in a final common pathway of disease progression.
- Overall better prognosis than other aggressive lymphomas.
- ALK-positive anaplastic large cell lymphoma is associated with a 5 year survival rate of 70-80%.
- ALK-positive anaplastic large cell lymphoma is associated with a 5 year survival rate of 30-40%.
- The International Prognostic Iindex (IPI) is used to estimate the prognosis of patients.
- The IPI takes into account 5 variables:
- Patient's age (>60 years)
- Elevated serum lactate dehydrogenase (LDH)
- Eastern Cooperative Oncology Group (ECOG) performance status
- Ann Arbor clinical stage III or IV
- Number of involved extra nodal sites > 1
- If any of this criteria is met, one point is awarded for the IPI. The interpretation of the total score is as follows:
- 0 to 1: Low risk
- 2: Low-intermediate risk
- 3: High-intermediate risk
- 4 to 5: High risk
- According to the International Peripheral T cell Lymphoma Project, the estimated 5-years survival for each of the IPI stages are as follows:[2]
- Low risk (IPI 0-1): 90%
- Low-intermediate risk (IPI 2): 68%
- High-intermediate risk (IPI 3): 23%
- High risk (IPI 4-5): 33%
- However, more recently, the International peripheral T-cell lymphoma Project score (IPTCLP) has demonstrated to be the most accurate score to predict overall survival in patients.[3] This score includes:
- Age
- Eastern Cooperative Oncology Group (ECOG) performance status
- Platelet count
References
- ↑ Agrawal K, Shet T, Sridhar E, Dhende S, Sengar M, Arora B; et al. (2017). "Story of survival in anaplastic large cell lymphoma - sometimes more than the anaplastic lymphoma kinase status: An evaluation of pathologic prognostic factors in 102 cases". Indian J Pathol Microbiol. 60 (4): 533–540. doi:10.4103/IJPM.IJPM_778_15. PMID 29323068.
- ↑ "ALK− anaplastic large-cell lymphoma is clinically and immunophenotypically different from both ALK+ ALCL and peripheral T-cell lymphoma, not otherwise specified: report from the International Peripheral T-Cell Lymphoma Project".
- ↑ "Comparison of four prognostic scores in peripheral T-cell lymphoma".