Anaplastic large cell lymphoma natural history, complications and prognosis: Difference between revisions
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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%. | 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=== | ===Natural History=== | ||
*If left untreated, patients with | *If left untreated, patients with anaplastic large cell lymphoma may progress to develop [[anemia]], [[intestinal obstruction]], and [[Immunosuppression|immuno-suppression]] thus causing infection. | ||
===Complications=== | ===Complications=== | ||
*Common complications of | *Common complications of anaplastic large cell lymphoma include: | ||
**Organ failure due metastasis | **Organ failure due [[metastasis]] | ||
** | **Immuno-suppression thus causing infection | ||
**CNS involvement causing: | **[[CNS]] involvement causing: | ||
***Meningitis | ***[[Meningitis]] | ||
***Visual disturbance | ***Visual disturbance | ||
***Facial numbness | ***Facial numbness | ||
Line 17: | Line 17: | ||
**Stroke due to vascular occlusion from leukemic cells | **Stroke due to vascular occlusion from leukemic cells | ||
==Prognosis== | ==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> | *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> | ||
* ALK-negative anaplastic large cell lymphomas represent other T-cell lymphomas in a final common pathway of disease progression | * 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 | * 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 70-80%. | ||
* ALK-positive anaplastic large cell lymphoma is associated with a 5 year survival rate of 30-40% | * 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 '''I'''nternational '''P'''rognostic '''I'''index (IPI) is used to estimate the prognosis of patients. | ||
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:* High risk (IPI 4-5): 33% | :* High risk (IPI 4-5): 33% | ||
* 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: | * 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 | :* Age | ||
:* Eastern Cooperative Oncology Group (ECOG) performance status | :* Eastern Cooperative Oncology Group (ECOG) performance status |
Revision as of 15:55, 7 March 2019
Anaplastic large cell lymphoma Microchapters |
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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]
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".