Anaplastic large cell lymphoma medical therapy
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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]
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:[1]
- Type of anaplastic large cell lymphoma
- Extent of anaplastic large cell lymphoma
| Type | Chemotherapy | Radiotherapy | Stem cell transplant | Surgery |
|---|---|---|---|---|
| Primary cutaneous anaplastic large cell lymphoma |
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| Primary systemic anaplastic large cell lymphoma |
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Chemotherapy[1]
- Anaplastic large cell lymphoma usually responds well to chemotherapy, so it often has a good prognosis
- It 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
Radiation therapy[1]
- Radiation therapy is most often given after chemotherapy
- 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[1]
- A stem cell transplant may be offered to some people with anaplastic large cell lymphoma who relapse after initial treatment
Although the peripheral T-cell lymphomas are a heterogenous group of pathologies, the treatment is the same:[2]
CHOP Regimen
- This regimen includes:
Some evidence suggest that although CHOP regimen is effective in treating the ALK(-) ALCL, a short 2-year event-free survival requires extra management[3], reason why CHOP regimen must then be followed by an autologous stem cell transplant during remission.[2]
Alternative Therapy
A novel drug, Brentuximab, has effectively treated refractory, CD30 positive ALCL in the japanese population.[4] The most common side effects associated with brentuximab are peripheral sensory neuropathy and neutropenia.[5]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Anaplastic large cell lymphoma. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/anaplastic-large-cell-lymphoma/?region=on Accessed on October 6,2015
- ↑ 2.0 2.1 Moskowitz AJ, Lunning MA, Horwitz SM (2014). "How I treat the peripheral T-cell lymphomas". Blood. 123 (17): 2636–44. doi:10.1182/blood-2013-12-516245. PMID 24615779.
- ↑ Rattarittamrong E, Norasetthada L, Tantiworawit A, Chai-Adisaksopha C, Nawarawong W (2013). "CHOEP-21 chemotherapy for newly diagnosed nodal peripheral T-cell lymphomas (PTCLs) in Maharaj Nakorn Chiang Mai Hospital". J Med Assoc Thai. 96 (11): 1416–22. PMID 24428090.
- ↑ Ogura M, Tobinai K, Hatake K, Ishizawa K, Uike N, Uchida T; et al. (2014). "Phase I / II study of brentuximab vedotin in Japanese patients with relapsed or refractory CD30-positive Hodgkin's lymphoma or systemic anaplastic large-cell lymphoma". Cancer Sci. 105 (7): 840–6. doi:10.1111/cas.12435. PMID 24814862.
- ↑ Terriou L, Bonnet S, Debarri H, Demarquette H, Morschhauser F (2013). "[Brentuximab vedotin: new treatment for CD30+ lymphomas]". Bull Cancer. 100 (7–8): 775–9. doi:10.1684/bdc.2013.1778. PMID 23831822.