Anaplastic large cell lymphoma medical therapy: 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==
==Overview==
The predominant therapy for anaplastic lymphoma is [[chemotherapy]]. Adjunctive [[radiotherapy]], [[stem cell transplantation]], and [[surgery]] may be required. The optimal therapy for anaplastic large cell lymphoma depends on the type and extent of anaplastic large cell lymphoma.
==Medical Therapy==
==Medical Therapy==
* Managed under "Aggressive Lymphoma" guidelines
* The optimal therapy for anaplastic large cell lymphoma depends on:
** [[CHOP]] is first line of treatment, CHOP-[[Rituxan]] in the unlikely scenario that [[CD20]] is positive, given that CD20 is a [[B-cell]] marker.  
:* Type of anaplastic large cell lymphoma
** [[Radiation therapy]] as per institutional preference (based on ECOG, SWOG, and GELA trials), but usually added for bulky disease
:* Extent of anaplastic large cell lymphoma
* Overall better prognosis than other "Aggressive Lymphomas"
 
** ALK+ 5-year survival 70-80%
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
** ALK- 5-year survival 30-40%
|+ '''Treatment for anaplastic large cell lymphoma'''
! style="background: #4479BA;; color:#FFF;" | Type
! style="background: #4479BA;; color:#FFF;" | Chemotherapy
! style="background: #4479BA;; color:#FFF;" | Radiotherapy
! style="background: #4479BA;; color:#FFF;" | Stem cell transplant
! style="background: #4479BA;; color:#FFF;" | Surgery
|-
| style="text-align: center; padding: 5px 5px; background: #F5F5F5;" | Primary cutaneous anaplastic large cell lymphoma
| style="padding: 5px 5px; background: #F5F5F5;" |
* Only used for people with extensive disease, where many areas of the skin are affected
* Used for people cannot be treated with localized treatment
| style="padding: 5px 5px; background: #F5F5F5;" |
* External beam radiation therapy to the area (for localized disease)
| style="padding: center; padding: 5px 5px; background: #F5F5F5;" | --------
| style="padding: 5px 5px; background: #F5F5F5;" |
* Surgery to remove the affected skin
|-
| style="text-align: center; padding: 5px 5px; background: #F5F5F5;" | Primary systemic anaplastic large cell lymphoma
| style="padding: 5px 5px; background: #F5F5F5;" |
* Drug Regimen: (CHOP) [[Cyclophosphamide]] {{and}} [[Doxorubicin]] {{and}} [[Vincristine]] {{and}} [[Prednisone]]
| style="padding: 5px 5px; background: #F5F5F5;" |
* May be offered
| style="padding: 5px 5px; background: #F5F5F5;" |
* May be offered
| style="padding: center; padding: 5px 5px; background: #F5F5F5;" | --------
|}
===Chemotherapy===
* Anaplastic large cell lymphoma usually responds well to chemotherapy, so it often has a good prognosis.
* Anaplastic large cell lymphoma is treated with the same combinations of chemotherapy drugs used to treat other aggressive lymphomas.
* Drug Regimen: ([[CHOP]]) [[Cyclophosphamide]] {{and}} [[Doxorubicin]] {{and}} [[Vincristine]] {{and}} [[Prednisone]]<ref name="pmid29516333">{{cite journal| author=Vu K, Ai W| title=Update on the Treatment of Anaplastic Large Cell Lymphoma. | journal=Curr Hematol Malig Rep | year= 2018 | volume= 13 | issue= 2 | pages= 135-141 | pmid=29516333 | doi=10.1007/s11899-018-0436-z | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29516333  }} </ref>
===Radiation therapy===
* Radiation therapy is most often given after chemotherapy.<ref name="JulieMann2017">{{cite journal|last1=Julie|first1=D.A.|last2=Mann|first2=J.M.|last3=Wu|first3=X.|last4=Nagar|first4=H.|title=Role of Adjuvant Radiotherapy for Early-Stage Anaplastic Large Cell Lymphoma: Analysis of the National Cancer Database|journal=International Journal of Radiation Oncology*Biology*Physics|volume=99|issue=2|year=2017|pages=S141|issn=03603016|doi=10.1016/j.ijrobp.2017.06.327}}</ref>
:[[External beam radiotherapy|External beam radiation therapy]] may be used:
:* When the lymphoma cells are only in one area of the lymph nodes (stage I primary systemic anaplastic large cell lymphoma).
:* For localized skin lesions in primary cutaneous anaplastic large cell lymphoma.


===Stem cell transplant===
* A [[stem cell transplant]] may be offered to patients with anaplastic large cell lymphoma who relapse after initial treatment.<ref name="pmid10929023">{{cite journal| author=Deconinck E, Lamy T, Foussard C, Gaillard F, Delwail V, Colombat P et al.| title=Autologous stem cell transplantation for anaplastic large-cell lymphomas: results of a prospective trial. | journal=Br J Haematol | year= 2000 | volume= 109 | issue= 4 | pages= 736-42 | pmid=10929023 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10929023  }} </ref>
==References==
==References==
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{{reflist|2}}
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[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Types of cancer]]
[[Category:Types of cancer]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Hematology]]
[[Category:Immunology]]

Latest revision as of 12:45, 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 predominant therapy for anaplastic lymphoma is chemotherapy. Adjunctive radiotherapy, stem cell transplantation, and surgery may be required. The optimal therapy for anaplastic large cell lymphoma depends on the type and extent of anaplastic large cell lymphoma.

Medical Therapy

  • The optimal therapy for anaplastic large cell lymphoma depends on:
  • Type of anaplastic large cell lymphoma
  • Extent of anaplastic large cell lymphoma
Treatment for anaplastic large cell lymphoma
Type Chemotherapy Radiotherapy Stem cell transplant Surgery
Primary cutaneous anaplastic large cell lymphoma
  • Only used for people with extensive disease, where many areas of the skin are affected
  • Used for people cannot be treated with localized treatment
  • External beam radiation therapy to the area (for localized disease)
 --------
  • Surgery to remove the affected skin
Primary systemic anaplastic large cell lymphoma
  • May be offered
  • May be offered
 --------

Chemotherapy

  • Anaplastic large cell lymphoma usually responds well to chemotherapy, so it often has a good prognosis.
  • Anaplastic large cell lymphoma is treated with the same combinations of chemotherapy drugs used to treat other aggressive lymphomas.
  • Drug Regimen: (CHOP) Cyclophosphamide AND Doxorubicin AND Vincristine AND Prednisone[1]

Radiation therapy

  • Radiation therapy is most often given after chemotherapy.[2]
External beam radiation therapy may be used:
  • When the lymphoma cells are only in one area of the lymph nodes (stage I primary systemic anaplastic large cell lymphoma).
  • For localized skin lesions in primary cutaneous anaplastic large cell lymphoma.

Stem cell transplant

  • A stem cell transplant may be offered to patients with anaplastic large cell lymphoma who relapse after initial treatment.[3]

References

  1. ↑ Vu K, Ai W (2018). "Update on the Treatment of Anaplastic Large Cell Lymphoma". Curr Hematol Malig Rep. 13 (2): 135–141. doi:10.1007/s11899-018-0436-z. PMID 29516333.
  2. ↑ Julie, D.A.; Mann, J.M.; Wu, X.; Nagar, H. (2017). "Role of Adjuvant Radiotherapy for Early-Stage Anaplastic Large Cell Lymphoma: Analysis of the National Cancer Database". International Journal of Radiation Oncology*Biology*Physics. 99 (2): S141. doi:10.1016/j.ijrobp.2017.06.327. ISSN 0360-3016.
  3. ↑ Deconinck E, Lamy T, Foussard C, Gaillard F, Delwail V, Colombat P; et al. (2000). "Autologous stem cell transplantation for anaplastic large-cell lymphomas: results of a prospective trial". Br J Haematol. 109 (4): 736–42. PMID 10929023.

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