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Khoubila N, Sraidi S, Madani A, Tazi I. Anaplastic Large-cell Lymphoma in Children: State of the Art in 2023. J Pediatr Hematol Oncol 2024; 46:217-224. [PMID: 38912833 DOI: 10.1097/mph.0000000000002875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 04/04/2024] [Indexed: 06/25/2024]
Abstract
Anaplastic large-cell lymphoma is a rare disease and account for approximately 10% to 15% of pediatric non-Hodgkin lymphomas. They are characterized by extended stages, a high frequency of B signs and extra nodal involvement. Multiagent chemotherapy cures ∽60% to 75% of patients and relapse occurs in 35% of cases. For relapsed patients, various treatments ranging from vinblastine monotherapy to therapeutic intensification with hematopoietic stem cell transplantation have been evaluated, but there is currently no consensus on the optimal therapeutic strategy. New therapeutic perspectives are being evaluated for relapses and refractory forms as well as high-risk forms including monoclonal antibodies (Anti CD30), ALK inhibitors, and CART cells.
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Affiliation(s)
- Nisrine Khoubila
- Department of Hematology and Pediatric Oncology, Hospital 20 August 1953, CHU Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca
| | - Sofia Sraidi
- Department of Hematology and Pediatric Oncology, Hospital 20 August 1953, CHU Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca
| | - Abdellah Madani
- Department of Hematology and Pediatric Oncology, Hospital 20 August 1953, CHU Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca
| | - Illias Tazi
- Department of Clinical Hematology, CHU Mohamed VI, Cadi Ayyad University, Marrakech, Morocco
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2
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Contarini G, Carraro E, Lovisa F, Martire G, Lo Nigro L, Sala A, Pillon M, Mussolin L. Quantitative assessment of minimal residual disease for monitoring of paediatric patients with relapsed/refractory anaplastic large-cell lymphoma treated with brentuximab vedotin: A case series. Br J Haematol 2024; 204:352-355. [PMID: 37822050 DOI: 10.1111/bjh.19151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023]
Affiliation(s)
- Giorgia Contarini
- Maternal and Child Health Department Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy
- Pediatric Research Institute "Città della Speranza", Padua, Italy
| | - Elisa Carraro
- Maternal and Child Health Department Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy
| | - Federica Lovisa
- Pediatric Research Institute "Città della Speranza", Padua, Italy
| | - Gaia Martire
- Maternal and Child Health Department Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy
- Pediatric Research Institute "Città della Speranza", Padua, Italy
| | - Luca Lo Nigro
- Center of Pediatric Hematology-Oncology, Azienda Policlinico-San Marco, Catania, Italy
| | - Alessandra Sala
- Department of Pediatric Hematology Oncology, Fondazione IRCCS San Gerardo dei Tintori, Centro Maria Letizia Verga, University of Milano-Bicocca, Monza, Italy
| | - Marta Pillon
- Maternal and Child Health Department Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy
| | - Lara Mussolin
- Maternal and Child Health Department Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy
- Pediatric Research Institute "Città della Speranza", Padua, Italy
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3
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Noguchi K, Ikawa Y. Strategy for Pediatric Patients with Relapsed or Refractory Anaplastic Lymphoma Kinase-Positive Anaplastic Large Cell Lymphoma: A Review. Cancers (Basel) 2023; 15:5733. [PMID: 38136278 PMCID: PMC10741612 DOI: 10.3390/cancers15245733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/10/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) is an aggressive T-cell lymphoma characterized by large T-cells with strong CD30 and ALK expression. Although conventional chemotherapy is effective in most patients, approximately 30% experience a relapse or refractory disease and have a poor prognosis. Several risk factors associated with poor prognosis have been identified in pediatric ALK-positive ALCL. These include morphological patterns with the small cell variant or lymphohistiocytic variant, leukemic presentation, the presence of minimal disseminated disease, or involvement of the central nervous system. Relapsed or refractory ALK-positive ALCL is often resistant to conventional chemotherapy; therefore, salvage therapy is required. In recent years, targeted therapies such as ALK inhibitors and brentuximab vedotin (BV) have been developed. ALK inhibitors block the continuous activation of ALK kinase, a driver mutation that leads to cell proliferation in ALK-positive ALCL. Additionally, BV is an antibody-drug conjugate that targets CD30-positive cells. Both ALK inhibitors and BV have displayed dramatic effects in chemoresistant ALK-positive ALCL. Weekly vinblastine treatment and hematopoietic stem cell transplantation have also been reported to be effective therapies. This article reviews pediatric ALK-positive ALCL, focusing on risk factors and treatment strategies for pediatric patients with relapsed or refractory ALK-positive ALCL.
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Affiliation(s)
| | - Yasuhiro Ikawa
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8641, Ishikawa, Japan;
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Prokoph N, Matthews JD, Trigg RM, Montes‐Mojarro IA, Burke GAA, Fend F, Merkel O, Kenner L, Geoerger B, Johnston R, Murray MJ, Riguad C, Brugières L, Turner SD. Patient-derived xenograft models of ALK+ ALCL reveal preclinical promise for therapy with brigatinib. Br J Haematol 2023; 202:985-994. [PMID: 37357529 PMCID: PMC10952693 DOI: 10.1111/bjh.18953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/09/2023] [Accepted: 06/15/2023] [Indexed: 06/27/2023]
Abstract
Anaplastic large-cell lymphoma (ALCL) is a T-cell malignancy predominantly driven by the oncogenic anaplastic lymphoma kinase (ALK), accounting for approximately 15% of all paediatric non-Hodgkin lymphoma. Patients with central nervous system (CNS) relapse are particularly difficult to treat with a 3-year overall survival of 49% and a median survival of 23.5 months. The second-generation ALK inhibitor brigatinib shows superior penetration of the blood-brain barrier unlike the first-generation drug crizotinib and has shown promising results in ALK+ non-small-cell lung cancer. However, the benefits of brigatinib in treating aggressive paediatric ALK+ ALCL are largely unknown. We established a patient-derived xenograft (PDX) resource from ALK+ ALCL patients at or before CNS relapse serving as models to facilitate the development of future therapies. We show in vivo that brigatinib is effective in inducing the remission of PDX models of crizotinib-resistant (ALK C1156Y, TP53 loss) ALCL and furthermore that it is superior to crizotinib as a second-line approach to the treatment of a standard chemotherapy relapsed/refractory ALCL PDX pointing to brigatinib as a future therapeutic option.
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Affiliation(s)
- Nina Prokoph
- Division of Cellular and Molecular Pathology, Department of PathologyUniversity of Cambridge, Addenbrooke's HospitalCambridgeUK
| | - Jamie D. Matthews
- Division of Cellular and Molecular Pathology, Department of PathologyUniversity of Cambridge, Addenbrooke's HospitalCambridgeUK
| | - Ricky M. Trigg
- Division of Cellular and Molecular Pathology, Department of PathologyUniversity of Cambridge, Addenbrooke's HospitalCambridgeUK
| | - Ivonne A. Montes‐Mojarro
- Institute of Pathology and Neuropathology and Comprehensive Cancer Center TübingenUniversity Hospital Tübingen, Eberhard‐Karls‐UniversityTübingenGermany
| | - G. A. Amos Burke
- Department of Paediatric Haematology and OncologyCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Falko Fend
- Institute of Pathology and Neuropathology and Comprehensive Cancer Center TübingenUniversity Hospital Tübingen, Eberhard‐Karls‐UniversityTübingenGermany
| | - Olaf Merkel
- Department of Experimental Pathology and Laboratory Animal Pathology, Institute of Clinical PathologyMedical University of ViennaViennaAustria
| | - Lukas Kenner
- Department of Experimental Pathology and Laboratory Animal Pathology, Institute of Clinical PathologyMedical University of ViennaViennaAustria
- Unit of Laboratory Animal PathologyUniversity of Veterinary Medicine ViennaViennaAustria
- Christian Doppler Laboratory for Applied MetabolomicsMedical University of ViennaViennaAustria
- Center for Biomarker Research in Medicine (CBmed) Vienna, Core‐Lab2Medical University of ViennaViennaAustria
| | - Birgit Geoerger
- Department of Pediatric and Adolescent OncologyGustave Roussy Cancer CenterVillejuifFrance
- INSERM U1015, Gustave Roussy Cancer CenterUniversité Paris‐SaclayVillejuifFrance
| | - Robert Johnston
- Department of Paediatric Oncology/HaematologyRoyal Belfast Hospital for Sick ChildrenBelfastUK
| | - Matthew J. Murray
- Division of Cellular and Molecular Pathology, Department of PathologyUniversity of Cambridge, Addenbrooke's HospitalCambridgeUK
- Department of Paediatric Haematology and OncologyCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Charlotte Riguad
- Department of Pediatric and Adolescent OncologyGustave Roussy Cancer CenterVillejuifFrance
| | - Laurence Brugières
- Department of Pediatric and Adolescent OncologyGustave Roussy Cancer CenterVillejuifFrance
| | - Suzanne D. Turner
- Division of Cellular and Molecular Pathology, Department of PathologyUniversity of Cambridge, Addenbrooke's HospitalCambridgeUK
- Institute of Medical Genetics and Genomics, Faculty of MedicineMasaryk UniversityBrnoCzech Republic
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5
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Brugières L, Cozic N, Houot R, Rigaud C, Sibon D, Arfi-Rouche J, Bories P, Cottereau AS, Delmer A, Ducassou S, Garnier N, Lamant L, Leruste A, Millot F, Moalla S, Morschhauser F, Nolla M, Pagnier A, Reguerre Y, Renaud L, Schmitt A, Simonin M, Verschuur A, Hoog Labouret N, Mahier Ait Oukhatar C, Vassal G. Efficacy and safety of crizotinib in ALK-positive systemic anaplastic large-cell lymphoma in children, adolescents, and adult patients: results of the French AcSé-crizotinib trial. Eur J Cancer 2023; 191:112984. [PMID: 37549532 DOI: 10.1016/j.ejca.2023.112984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/27/2023] [Accepted: 07/05/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND The French phase II AcSé-crizotinib trial aimed to evaluate the safety and efficacy of crizotinib in patients with ALK, ROS1, and MET-driven malignancies, including ALK-positive anaplastic large-cell lymphoma (ALK+ ALCL). METHODS ALK+ ALCL patients 12 months or older with measurable disease and no standard care options available received crizotinib twice daily at 165 mg/m2 in children and adolescents and 250 mg in adults. The primary end-point was the response rate at 8 weeks. RESULTS Twenty-eight patients were enroled between February 2014 and March 2018. Three patients who were not treated were excluded from the analysis. The median age was 19 years. The median previous line of chemotherapy was two. In the 24 patients with an evaluable response, the response rate at 8 weeks was 67% (95% CI: 47-82%). All patients discontinued crizotinib after a median treatment duration of 3.7 months: eight for progression, two for adverse events (AEs) related to prior treatments, and 15 by choice, including six for allogeneic stem-cell transplantation. The median follow-up was 45 months. Nine patients experienced an event: eight relapses (seven after crizotinib discontinuation and one after dose reduction), and one died in complete remission. The median duration of response was 43.3 months (95% CI: 8.3-not reached). The 3-year progression-free and overall survival rates were 40% (95% CI: 23-59%) and 63% (95% CI: 43-79%). Grade 3 or 4 treatment-related AEs occurred in 32% of patients. CONCLUSION Crizotinib shows efficacy and an acceptable safety profile in ALK+ ALCL relapsed/refractory patients. However, a large proportion of patients experience a relapse after crizotinib discontinuation. Future studies will assess if prolonged ALK inhibitor exposure has curative potential without consolidation.
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Affiliation(s)
- Laurence Brugières
- Department of Children and Adolescent Oncology, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France.
| | - Nathalie Cozic
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Oncostat U1018 INSERM, Labeled Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France
| | - Roch Houot
- Department of Hematology, CHU de Rennes, Université de Rennes, Rennes, France
| | - Charlotte Rigaud
- Department of Children and Adolescent Oncology, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | - David Sibon
- Lymphoid Malignancies Department, Henri Mondor University Hospital, AP-HP, Creteil, France
| | - Julia Arfi-Rouche
- Department of Radiology, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | - Pierre Bories
- Institut Universitaire du Cancer - Oncopole, Toulouse, France
| | - Anne S Cottereau
- Department of Nuclear Medicine, Cochin Hospital, AP-HP, University of Paris, Paris, France
| | - Alain Delmer
- Department of Hematology, University Hospital of Reims and UFR Médecine, Reims, France
| | | | - Nathalie Garnier
- Institut d'Hematologie et d'Oncologie Pediatrique, Hospices Civils de Lyon, Lyon, France
| | - Laurence Lamant
- Department of Pathology, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France Université Toulouse III-Paul Sabatier; UMR1037 CRCT, Toulouse, France
| | - Amaury Leruste
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, PSL Research University, Paris, France
| | | | - S Moalla
- Institut Universitaire du Cancer - Oncopole, Toulouse, France
| | - Franck Morschhauser
- ULR 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, Univ. Lille, CHU Lille, Lille, France
| | - Marie Nolla
- Pediatric Hematology-Immunology, CHU Toulouse Purpan, France
| | - Anne Pagnier
- Pediatric Immunology Hematology and Oncology, CHU Grenoble Alpes, France
| | - Yves Reguerre
- CHU de Saint Denis de La Réunion Service d'Oncologie et d'Hématologie Pédiatrique, Saint Denis, France
| | - Loic Renaud
- Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Hemato-Oncologie, DMU DHI; Université de Paris, Paris, France
| | - Anne Schmitt
- Hématologie, Institut Bergonié, Bordeaux, France
| | - Mathieu Simonin
- Department of Pediatric Hematology and Oncology, Assistance Publique-Hôpitaux de Paris Armand Trousseau Hospital, Sorbonne Université, Paris, France
| | - Arnaud Verschuur
- Department of Pediatric Hematology-Oncology, La Timone University Hospital, APHM, Marseille, France
| | | | | | - Gilles Vassal
- Department of Children and Adolescent Oncology, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
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Beishuizen A, Mellgren K, Andrés M, Auperin A, Bacon CM, Bomken S, Burke GAA, Burkhardt B, Brugieres L, Chiang AKS, Damm-Welk C, d'Amore E, Horibe K, Kabickova E, Khanam T, Kontny U, Klapper W, Lamant L, Le Deley MC, Loeffen J, Macintyre E, Mann G, Meyer-Wentrup F, Michgehl U, Minard-Colin V, Mussolin L, Oschlies I, Patte C, Pillon M, Reiter A, Rigaud C, Roncery L, Salaverria I, Simonitsch-Klupp I, Uyttebroeck A, Verdu-Amoros J, Williams D, Woessmann W, Wotherspoon A, Wrobel G, Zimmermann M, Attarbaschi A, Turner SD. Improving outcomes of childhood and young adult non-Hodgkin lymphoma: 25 years of research and collaboration within the framework of the European Intergroup for Childhood Non-Hodgkin Lymphoma. Lancet Haematol 2023; 10:e213-e224. [PMID: 36858678 DOI: 10.1016/s2352-3026(22)00374-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/01/2022] [Accepted: 11/18/2022] [Indexed: 03/03/2023]
Abstract
The European Intergroup for Childhood Non-Hodgkin Lymphoma (EICNHL) was established 25 years ago with the goal to facilitate clinical trials and research collaborations in the field both within Europe and worldwide. Since its inception, much progress has been made whereby major improvements in outcomes have been achieved. In this Review, we describe the different diagnostic entities of non-Hodgkin lymphoma in children and young adults describing key features of each entity and outlining clinical achievements made in the context of the EICNHL framework. Furthermore, we provide an overview of advances in biopathology with an emphasis on the role of biological studies and how they have shaped available treatments. Finally, for each entity, we describe future goals, upcoming clinical trials, and highlight areas of research that require our focus going forward.
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Affiliation(s)
- Auke Beishuizen
- Division of Hemato-Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; The Netherlands and Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Karin Mellgren
- Department of Paediatric Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mara Andrés
- Department of Pediatric Oncology, University Hospital Le Fe, Valencia, Spain
| | - Anne Auperin
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Chris M Bacon
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Wolfson Childhood Cancer Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Simon Bomken
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Wolfson Childhood Cancer Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - G A Amos Burke
- Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge
| | - Birgit Burkhardt
- Department of Pediatric Hematology, Oncology, and BMT, University Hospital Muenster, Münster, Germany
| | - Laurence Brugieres
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Alan K S Chiang
- Department of Pediatrics & AdolescentMedicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - Christine Damm-Welk
- Pediatric Hematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Emanuele d'Amore
- Department of Pathological Anatomy, San Bortolo Hospital, Vicenza, Italy
| | - Keizo Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Aichi, Japan
| | - Edita Kabickova
- Department of Pediatric Hematology and Oncology, Charles University & University Hospital Motol, Prague, Czech Republic
| | - Tasneem Khanam
- Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge
| | - Udo Kontny
- Section of Pediatric Hematology, Oncology, and Stem Cell Transplantation, Department of Pediatric and Adolescent Medicine, RWTH Aachen University Hospital, Aachen, Germany
| | - Wolfram Klapper
- Institute of Pathology, Hematopathology Section, University of Schleswig-Holstein, Kiel, Germany
| | - Laurence Lamant
- Université Toulouse III-Paul Sabatier, Laboratoire d'Excellence Toulouse Cancer-TOUCAN, Équipe Labellisée La Ligue Contre Le Cancer, Inserm, Toulouse, France
| | | | - Jan Loeffen
- Division of Hemato-Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Elizabeth Macintyre
- Onco-hematology, Université Paris Cité and Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Georg Mann
- Pediatric Hematology and Oncology, Erasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Friederike Meyer-Wentrup
- Division of Hemato-Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Ulf Michgehl
- Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge
| | - Veronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Lara Mussolin
- Istituto di Ricerca Pediatrica Città della Speranza, Padua, Italy; Pediatric Hematology, Oncology and Stem Cell Transplant Division, Maternal and Child Health Department, Padova University Hospital, Padova, Italy
| | - Ilske Oschlies
- Institute of Pathology, Hematopathology Section, University of Schleswig-Holstein, Kiel, Germany
| | - Catherine Patte
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Marta Pillon
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Maternal and Child Health Department, Padova University Hospital, Padova, Italy
| | - Alfred Reiter
- Department of Pediatric Hematology and Oncology, Justus Liebig-University Giessen, Giessen, Germany
| | - Charlotte Rigaud
- Department of Pediatric Hematology, Oncology, and BMT, University Hospital Muenster, Münster, Germany
| | - Leila Roncery
- St Anna Children's Hospital, Department of Paediatric Haematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Itziar Salaverria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospital Leuven,KU Leuven, Leuven, Belgium
| | - Jaime Verdu-Amoros
- Department of Pediatric Hematology and Oncology, University Hospital Valencia, Valencia, Spain
| | - Denise Williams
- Wolfson Childhood Cancer Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Wilhelm Woessmann
- Pediatric Hematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - Grazyna Wrobel
- Bone Marrow Transplantation and Pediatric Hematology and Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Martin Zimmermann
- Hannover Medical School, Department of Pediatric Hematology and Oncology, Hannover, Germany
| | - Andishe Attarbaschi
- St Anna Children's Hospital, Department of Paediatric Haematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Suzanne D Turner
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK; Central European Institute for Technology, Masaryk University, Brno, Czech Republic.
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Rigaud C, Knörr F, Brugières L, Woessmann W. Diagnosis and management of ALK-positive anaplastic large cell lymphoma in children and adolescents. Best Pract Res Clin Haematol 2023; 36:101444. [PMID: 36907641 DOI: 10.1016/j.beha.2023.101444] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) is a CD30-positive T cell lymphoma characterized by signalling from constitutively activated ALK fusion proteins. Most children and adolescents present in advanced stages, often with extranodal disease and B symptoms. The current front-line therapy standard of six cycles polychemotherapy reaches an event-free survival of 70%. The strongest independent prognostic factors are minimal disseminated disease and early minimal residual disease. At relapse, ALK-inhibitors, Brentuximab Vedotin, Vinblastine, or second line chemotherapy are effective re-inductions. Survival at relapse exceeds 60-70% with consolidation according to the time of relapse (Vinblastine monotherapy or allogeneic hematopoietic stem cell transplantation) so that the overall survival reaches 95%. It needs to be shown whether check-point inhibitors or long-term ALK-inhibition may substitute for transplantation. The future necessitates international cooperative trials testing whether a shift of paradigm to a chemotherapy-free regimen can cure ALK-positive ALCL.
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Affiliation(s)
- Charlotte Rigaud
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France.
| | - Fabian Knörr
- NHL-BFM Study Centre and Pediatric Hematology and Oncology, University Medical Centre Hamburg-Eppendorf, 20246, Hamburg, Germany; Mildred Scheel Cancer Career Centre HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Laurence Brugières
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France.
| | - Wilhelm Woessmann
- NHL-BFM Study Centre and Pediatric Hematology and Oncology, University Medical Centre Hamburg-Eppendorf, 20246, Hamburg, Germany.
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Management of Aggressive Non-Hodgkin Lymphomas in the Pediatric, Adolescent, and Young Adult Population: An Adult vs. Pediatric Perspective. Cancers (Basel) 2022; 14:cancers14122912. [PMID: 35740580 PMCID: PMC9221186 DOI: 10.3390/cancers14122912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/04/2022] [Accepted: 06/08/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary This review details the diagnosis and treatment of primary non-Hodgkin lymphoma (NHL) in the pediatric and adolescent population. We also describe treatment modalities such as hematopoietic stem cell transplantation for relapsed or refractory NHL in patients that fail or do not respond to the initial therapy. We then detail the current advancements in treatment for patients that fail initial therapy such as CAR T-cell therapy, the use of immunotherapy that target surface makers on malignant cells and highlight areas where further research is needed. The purpose of our review is to inform the pediatric oncology community in regard to the various types of NHLs and emphasize areas where the science is evolving in the treatment of primary, relapsed or refractory disease. Abstract Non-Hodgkin lymphoma (NHL) is a broad entity which comprises a number of different types of lymphomatous malignancies. In the pediatric and adolescent population, the type and prognosis of NHL varies by age and gender. In comparison to adults, pediatric and adolescent patients generally have better outcomes following treatment for primary NHL. However, relapsed/refractory (R/R) disease is associated with poorer outcomes in many types of NHL such as diffuse large B cell lymphoma and Burkitt lymphoma. Newer therapies have been approved in the use of primary NHL in the pediatric and adolescent population such as Rituximab and other therapies such as chimeric antigen receptor T-cell (CAR T-cell) therapy are under investigation for the treatment of R/R NHL. In this review, we feature the characteristics, diagnosis, and treatments of the most common NHLs in the pediatric and adolescent population and also highlight the differences that exist between pediatric and adult disease. We then detail the areas of treatment advances such as immunotherapy with CAR T-cells, brentuximab vedotin, and blinatumomab as well as cell cycle inhibitors and describe areas where further research is needed. The aim of this review is to juxtapose established research regarding pediatric and adolescent NHL with recent advancements as well as highlight treatment gaps where more investigation is needed.
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Pokorna P, Lakka Klement G, Vasikova A, Kanderova V, Jezova M, Noskova K, Mudry P, Kyr M, Merta T, Bajciova V, Krenova Z, Palova H, Valik D, Zdrazilova Dubska L, Slaby O, Sterba J. Minimal Residual Disease-Guided Intermittent Dosing in Patients With Cancer: Successful Treatment of Chemoresistant Anaplastic Large Cell Lymphoma Using Intermittent Lorlatinib Dosing. JCO Precis Oncol 2022; 6:e2100525. [PMID: 35700412 PMCID: PMC9384955 DOI: 10.1200/po.21.00525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Petra Pokorna
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Giannoula Lakka Klement
- Department of Pediatric Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,CSTS Health Care, Toronto, ON, Canada
| | - Alzbeta Vasikova
- Department of Internal Medicine-Hematology and Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Veronika Kanderova
- CLIP, Department of Pediatric Hematology/Oncology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Marta Jezova
- Department of Pathology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Kristyna Noskova
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Clinical Pharmacy Section of Hospital Pharmacy, University Hospital Brno, Brno, Czech Republic
| | - Peter Mudry
- Department of Pediatric Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Michal Kyr
- Department of Pediatric Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tomas Merta
- Department of Pediatric Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Viera Bajciova
- Department of Pediatric Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Zdenka Krenova
- Department of Pediatric Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Hana Palova
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Dalibor Valik
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lenka Zdrazilova Dubska
- Department of Clinical Microbiology and Immunology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Ondrej Slaby
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic.,Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jaroslav Sterba
- Department of Pediatric Oncology, University Hospital Brno, and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic
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10
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Gene Expression Signature Associated with Clinical Outcome in ALK-Positive Anaplastic Large Cell Lymphoma. Cancers (Basel) 2021; 13:cancers13215523. [PMID: 34771686 PMCID: PMC8582782 DOI: 10.3390/cancers13215523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/15/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Anaplastic large cell lymphomas associated with ALK translocation have a good outcome after CHOP treatment; however, the 2-year relapse rate remains at 30%. Microarray gene-expression profiling, high throughput RT-qPCR, and RNA sequencing of 48 ALK-positive anaplastic large cell lymphoma (ALK+ ALCL) samples obtained at diagnosis enable the identification of genes associated with clinical outcome. More particularly, our molecular signatures indicate that the FN1 gene, a matrix key regulator, might also be involved in the prognosis and the therapeutic response in anaplastic lymphomas. Abstract Anaplastic large cell lymphomas associated with ALK translocation have a good outcome after CHOP treatment; however, the 2-year relapse rate remains at 30%. Microarray gene-expression profiling of 48 samples obtained at diagnosis was used to identify 47 genes that were differentially expressed between patients with early relapse/progression and no relapse. In the relapsing group, the most significant overrepresented genes were related to the regulation of the immune response and T-cell activation while those in the non-relapsing group were involved in the extracellular matrix. Fluidigm technology gave concordant results for 29 genes, of which FN1, FAM179A, and SLC40A1 had the strongest predictive power after logistic regression and two classification algorithms. In parallel with 39 samples, we used a Kallisto/Sleuth pipeline to analyze RNA sequencing data and identified 20 genes common to the 28 genes validated by Fluidigm technology—notably, the FAM179A and FN1 genes. Interestingly, FN1 also belongs to the gene signature predicting longer survival in diffuse large B-cell lymphomas treated with CHOP. Thus, our molecular signatures indicate that the FN1 gene, a matrix key regulator, might also be involved in the prognosis and the therapeutic response in anaplastic lymphomas.
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11
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Iwafuchi H, Nakazawa A, Sekimizu M, Mori T, Osumi T, Iijima-Yamashita Y, Ohki K, Kiyokawa N, Fukano R, Saito AM, Horibe K, Kobayashi R. Clinicopathological features and prognostic significance of programmed death ligand 1 in pediatric ALK-positive anaplastic large cell lymphoma: results of the ALCL99 treatment in Japan. Hum Pathol 2021; 116:112-121. [PMID: 34363798 DOI: 10.1016/j.humpath.2021.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/17/2021] [Accepted: 07/29/2021] [Indexed: 12/27/2022]
Abstract
Programmed cell death 1/programmed death ligand 1 (PD-1/PD-L1) blockade is a promising therapy for hematological malignancies. However, the association of PD-L1 expression with the clinicopathological features and prognosis in pediatric ALK-positive anaplastic large cell lymphoma (ALCL) remains unclear. Using PD-L1/ALK immunofluorescence double staining, we evaluated the PD-L1 expression on tumor cells/tumor-infiltrating immune cells (TIICs) and the quantity of TIICs in 54 children with ALK-positive ALCL treated with the ALCL99 protocol. The percentages of PD-L1-positive tumor cells were significantly lower in patients with skin/mediastinum involvement, clinical high-risk group, present minimal disseminated disease (MDD), and a low ALK-antibody titer. The percentages of PD-L1-positive TIICs were significantly higher in patients with absent MDD. The percentages of TIICs were significantly lower in patients with absent MDD and a common morphological pattern. We classified patients according to the PD-L1 expression on tumor cells (Tumor-PD-L1), PD-L1 expression on TIICs (TIIC-PD-L1), and quantity of TIICs (TIIC-quantity). The progression-free survival (PFS) did not differ between Tumor-PD-L1high and Tumor-PD-L1low ALCL; TIIC-PD-L1high and TIIC-PD-L1low ALCL; and TIIC-quantityhigh and TIIC-quantitylow ALCL. According to the combined parameters of Tumor-PD-L1 and TIIC-quantity, Tumor-PD-L1high/TIIC-quantityhigh ALCL had a worse 5-year PFS than other ALCL (50% versus 83%; P = .009). Tumor-PD-L1high/TIIC-quantityhigh ALCL remained a significant prognostic factor in multivariate analysis (P = .044). This is the first study to demonstrate that a high tumoral PD-L1 expression with a high quantity of TIICs was associated with a poor prognosis in pediatric ALK-positive ALCL. The tumor microenvironment of ALK-positive ALCL may be relevant to the clinicopathological features and prognosis.
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Affiliation(s)
- Hideto Iwafuchi
- Department of Pathology, Shizuoka Children's Hospital, Shizuoka, 420-8660, Japan; Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, 460-0001, Japan; Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, 157-8535, Japan.
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama, 330-8777, Japan
| | - Masahiro Sekimizu
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, 460-0001, Japan; Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, 460-0001, Japan
| | - Tetsuya Mori
- Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, 216-8511, Japan
| | - Tomoo Osumi
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, 157-8535, Japan
| | - Yuka Iijima-Yamashita
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, 460-0001, Japan
| | - Kentaro Ohki
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, 157-8535, Japan
| | - Nobutaka Kiyokawa
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, 157-8535, Japan
| | - Reiji Fukano
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, 755-8505, Japan
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, 460-0001, Japan
| | - Keizo Horibe
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, 460-0001, Japan; Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, 460-0001, Japan
| | - Ryoji Kobayashi
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, 003-0006, Japan
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12
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Isolated Central Nervous System Progression During Systemic Treatment With Brentuximab Vedotin Monotherapy in a Pediatric Patient With Recurrent ALK-negative Anaplastic Large Cell Lymphoma. J Pediatr Hematol Oncol 2021; 43:e864-e866. [PMID: 32769561 DOI: 10.1097/mph.0000000000001914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/09/2020] [Indexed: 11/26/2022]
Abstract
Central nervous system (CNS) involvement in anaplastic large cell lymphoma (ALCL) is uncommon. CNS prophylaxis is not regularly included in second-line treatments for patients who develop CNS-negative relapses. We report a pediatric case of recurrent ALK-negative ALCL who developed isolated CNS progression during the treatment with brentuximab vedotin monotherapy. The patient achieved CNS remission after receiving the CNS-directed treatments including craniospinal irradiation. There is no evidence regarding whether brentuximab vedotin can cross the blood-brain barrier. CNS prophylaxis should be considered in high-risk patients with relapsed ALCL who receive second-line treatments containing agents with limited CNS penetration.
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13
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Mason EF, Kovach AE. Update on Pediatric and Young Adult Mature Lymphomas. Clin Lab Med 2021; 41:359-387. [PMID: 34304770 DOI: 10.1016/j.cll.2021.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
After acute leukemia and brain and central nervous system tumors, mature lymphomas represent the third most common cancer in pediatric patients. Non-Hodgkin lymphoma accounts for approximately 60% of lymphoma diagnoses in children, with the remainder representing Hodgkin lymphoma. Among non-Hodgkin lymphomas in pediatric patients, aggressive lymphomas, such as Burkitt lymphoma, diffuse large B-cell lymphoma, and anaplastic large cell lymphoma, predominate. This article summarizes the epidemiologic, histopathologic, and molecular features of selected mature systemic B-cell and T-cell lymphomas encountered in this age group.
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Affiliation(s)
- Emily F Mason
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, 4603A TVC, Nashville, TN 37232-5310, USA.
| | - Alexandra E Kovach
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #32, Los Angeles, CA 90027, USA
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14
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Raffa EH, Branson HM, Ngan B, Alexander S, Abla O. Central nervous system relapse in a child with anaplastic large cell lymphoma: potential for new therapeutic strategies. Cancer Rep (Hoboken) 2021; 4:e1377. [PMID: 33822480 PMCID: PMC8551994 DOI: 10.1002/cnr2.1377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/11/2021] [Accepted: 03/01/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Central nervous system (CNS) relapse is rare in childhood anaplastic large cell lymphoma (ALCL) and is associated with a poor prognosis. CASE We describe an 8-year-old boy with ALCL who developed an early CNS relapse without initial CNS disease. Despite aggressive medical management, the patient's neurological status deteriorated rapidly and he died shortly after. CONCLUSION Optimal treatment for children with relapsed ALCL involving the CNS remains unclear. Novel agents, including ALK inhibitors, that have CNS-penetration might be helpful and pediatric studies are warranted.
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Affiliation(s)
- Enass H Raffa
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Helen M Branson
- Division of Neuroradiology, Department of Diagnostic Radiology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Bo Ngan
- Division of Pathology, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Alexander
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Oussama Abla
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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15
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16
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Brentuximab vedotin in combination with chemotherapy for pediatric patients with ALK+ ALCL: results of COG trial ANHL12P1. Blood 2021; 137:3595-3603. [PMID: 33684925 PMCID: PMC8462406 DOI: 10.1182/blood.2020009806] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/24/2021] [Indexed: 11/20/2022] Open
Abstract
The addition of brentuximab vedotin was tolerable and prevented relapses, and EFS compares favorably with conventional chemotherapy. The study confirmed that minimal disseminated disease detection in peripheral blood was prognostic, with a significant impact on EFS.
Approximately 30% of pediatric patients with anaplastic large cell lymphoma (ALCL) relapse. Although brentuximab vedotin has demonstrated excellent activity in ALCL, it has not been used for newly diagnosed patients. Children’s Oncology Group (COG) trial ANHL12P1 determined the toxicity and efficacy of brentuximab vedotin with chemotherapy in children with newly diagnosed nonlocalized anaplastic large cell lymphoma kinase (ALK)+/CD30+ ALCL. From 2013 to 2017, 68 children with ALK+ ALCL were enrolled and received brentuximab vedotin. All patients received 5-day prophase, followed by 6 cycles of chemotherapy. Brentuximab vedotin was given on day 1 of each of the 6 cycles. Of the 67 patients eligible for toxicity evaluation, 66 completed all 6 cycles of chemotherapy, resulting in 399 evaluable cycles. There were no toxic deaths, no case of progressive multifocal leukoencephalopathy syndrome, and no case of grade 3 or 4 neuropathy. The 2-year event-free survival (EFS) was 79.1% (95% confidence interval [CI], 67.2-87.1). The 2-year overall survival (OS) was 97.0% (95% CI, 88.1-99.2). Fourteen patients relapsed. Eleven of 14 (79%) relapses occurred within 10 months of diagnosis; only 1 patient (1.5%) relapsed during therapy. Quantitative reverse transcription polymerase chain reaction for NPM-ALK at baseline (minimal disseminated disease) demonstrated prognostic value for EFS (P = .0004). Overall, the addition of brentuximab vedotin to standard chemotherapy does not add significant toxicity or alter the desired interval between cycles. The addition of brentuximab vedotin prevented relapses during therapy, and the OS and EFS estimates compare favorably with results obtained using conventional chemotherapy. This trial was registered at www.clinicaltrials.gov as #NCT01979536.
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17
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NPM-ALK: A Driver of Lymphoma Pathogenesis and a Therapeutic Target. Cancers (Basel) 2021; 13:cancers13010144. [PMID: 33466277 PMCID: PMC7795840 DOI: 10.3390/cancers13010144] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Anaplastic lymphoma kinase (ALK) is a tyrosine kinase associated with Anaplastic Large Cell lymphoma (ALCL) through oncogenic translocations mainly NPM-ALK. Chemotherapy is effective in ALK(+) ALCL patients and induces remission rates of approximately 80%. The remaining patients do not respond to chemotherapy and some patients have drug-resistant relapses. Different classes of ALK tyrosine kinase inhibitors (TKI) are available but used exclusively for EML4-ALK (+) lung cancers. The significant toxicities of most ALK inhibitors explain the delay in their use in pediatric ALCL patients. Some ALCL patients do not respond to the first generation TKI or develop an acquired resistance. Combination therapy with ALK inhibitors in ALCL is the current challenge. Abstract Initially discovered in anaplastic large cell lymphoma (ALCL), the ALK anaplastic lymphoma kinase is a tyrosine kinase which is affected in lymphomas by oncogenic translocations, mainly NPM-ALK. To date, chemotherapy remains a viable option in ALCL patients with ALK translocations as it leads to remission rates of approximately 80%. However, the remaining patients do not respond to chemotherapy and some patients have drug-resistant relapses. It is therefore crucial to identify new and better treatment options. Nowadays, different classes of ALK tyrosine kinase inhibitors (TKI) are available and used exclusively for EML4-ALK (+) lung cancers. In fact, the significant toxicities of most ALK inhibitors explain the delay in their use in ALCL patients, who are predominantly children. Moreover, some ALCL patients do not respond to Crizotinib, the first generation TKI, or develop an acquired resistance months following an initial response. Combination therapy with ALK inhibitors in ALCL is the current challenge.
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18
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Knörr F, Brugières L, Pillon M, Zimmermann M, Ruf S, Attarbaschi A, Mellgren K, Burke GAA, Uyttebroeck A, Wróbel G, Beishuizen A, Aladjidi N, Reiter A, Woessmann W. Stem Cell Transplantation and Vinblastine Monotherapy for Relapsed Pediatric Anaplastic Large Cell Lymphoma: Results of the International, Prospective ALCL-Relapse Trial. J Clin Oncol 2020; 38:3999-4009. [DOI: 10.1200/jco.20.00157] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To analyze the efficacy of a risk-stratified treatment of children with relapsed anaplastic large cell lymphoma (ALCL). The ALCL-Relapse trial (ClinicalTrials.gov identifier: NCT00317408 ) stratified patients according to the time of relapse and CD3 expression to prospectively test reinduction approaches combined with consolidation by allogeneic or autologous hematopoietic stem cell transplantation (SCT) and vinblastine monotherapy. PATIENTS AND METHODS Patients with progression during frontline therapy (very high risk) or a CD3-positive relapse (high risk) were scheduled for allogeneic SCT after reinduction chemotherapy. Patients with a CD3-negative relapse within 1 year after initial diagnosis or prior exposure to vinblastine (intermediate risk) received autologous SCT after carmustine-etoposide-cytarabine-melphalan. This arm was terminated prematurely, and subsequent patients received vinblastine monotherapy instead. Patients with a CD3-negative relapse > 1 year after initial diagnosis (low risk) received vinblastine monotherapy. RESULTS One hundred sixteen patients met the inclusion criteria; 105 evaluable patients with CNS-negative disease had a 5-year event-free survival (EFS) of 53% ± 5% and a 5-year overall survival (OS) of 78% ± 4%. Before termination of autologous SCT, EFS rates of patients in the very-high- (n = 17), high- (n = 26), intermediate- (n = 32), and low- (n = 21) risk groups were 41% ± 12%, 62% ± 10%, 44% ± 9%, and 81% ± 9%; the respective OS rates were 59% ± 12%, 73% ± 9%, 78% ± 7%, and 90% ± 6%. Analyzing only the patients in the intermediate-risk group consolidated per protocol by autologous SCT, EFS and OS of 23 patients were 30% ± 10% and 78% ± 9%, respectively. All 5 patients with intermediate risk receiving vinblastine monotherapy after the amendment experienced relapse again. CONCLUSION Shorter time to relapse was the strongest predictor of subsequent relapse. Allogeneic SCT offers a chance for cure in patients with high-risk ALCL relapse. For early relapsed ALCL autologous SCT was not effective. Vinblastine monotherapy achieved cure in patients with late relapse; however, it was not effective for early relapses.
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Affiliation(s)
- Fabian Knörr
- Pediatric Hematology and Oncology, University Hospital Hamburg-Eppendorf, Germany
| | - Laurence Brugières
- Department of Children and Adolescents Oncology, Gustave Roussy University Hospital, Paris-Saclay University, Villejuif, France
| | - Marta Pillon
- Pediatric Hematology and Oncology, University Hospital of Padova, Italy
| | - Martin Zimmermann
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Germany
| | - Stephanie Ruf
- Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen, Germany
| | - Andishe Attarbaschi
- Pediatric Hematology and Oncology, St Anna Children's Hospital, Medical University of Vienna, Austria
| | - Karin Mellgren
- Department of Pediatric Oncology and Hematology, The Queen Silvia Children's Hospital, Göteborg, Sweden
| | - G. Amos A. Burke
- Department of Pediatric Hematology, Oncology and Palliative Care, Cambridge University Hospital NHS Trust, Cambridge, United Kingdom
| | - Anne Uyttebroeck
- Department of Pediatric Oncology & Hematology, University Hospitals Leuven, Belgium
| | - Grażyna Wróbel
- Department of Bone Marrow Transplantation, Children's Oncology and Hematology, Wroclaw Medical University, Poland
| | - Auke Beishuizen
- Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Nathalie Aladjidi
- Department of Pediatric Hematology and Oncology, CIC1401, INSERM CICP, University Hospital of Bordeaux, France
| | - Alfred Reiter
- Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen, Germany
| | - Wilhelm Woessmann
- Pediatric Hematology and Oncology, University Hospital Hamburg-Eppendorf, Germany
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19
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Brentuximab Vedotin and High-dose Methotrexate Administrated Alternately for Refractory Anaplastic Large-cell Lymphoma With Central Nervous System Disease. J Pediatr Hematol Oncol 2020; 42:e456-e458. [PMID: 31274669 DOI: 10.1097/mph.0000000000001550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Pediatric anaplastic large-cell lymphoma (ALCL), which is characterized by strong expression of CD30, is usually responsive to multidrug chemotherapy. Brentuximab vedotin (BV) which is an anti-CD30 antibody-drug conjugate is a promising drug with effects on relapsing or refractory ALCL. However, its effects may not be sufficient for the central nervous system disease. The authors herein reported an 11-year-old boy with ALCL that progressed as central nervous system disease receiving intensive induction chemotherapy has achieved and maintained remission by BV and high-dose methotrexate administrated alternately. Alternate therapy with high-dose methotrexate may complement these shortcomings of BV to provide safe treatment without worsening adverse events.
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20
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Del Baldo G, Abbas R, Woessmann W, Horibe K, Pillon M, Burke A, Beishuizen A, Rigaud C, Le Deley MC, Lamant L, Brugières L. Neuro-meningeal relapse in anaplastic large-cell lymphoma: incidence, risk factors and prognosis - a report from the European intergroup for childhood non-Hodgkin lymphoma. Br J Haematol 2020; 192:1039-1048. [PMID: 32648260 DOI: 10.1111/bjh.16755] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/25/2020] [Indexed: 12/26/2022]
Abstract
Relapses involving the central nervous system (CNS) are rare in children and adolescents with ALK+ anaplastic large cell lymphoma (ALCL) treated with regimens including CNS prophylaxis. Early identification of patients at high-risk for CNS relapse would enable stratification and better adaptation of initial treatment especially in the light of the upcoming targeted therapies with limited CNS penetration. We analyzed clinical and histological data of all ALK+ALCL patients with CNS relapse registered in ALCL99-database with the aim to describe risk factors and outcome. Characteristics of patients with no relapse, relapse without CNS involvement and CNS relapse were compared. At a median follow-up of 8 years (0.05-18 years), a CNS involvement was reported at first or subsequent relapse in 26/618 patients. Median interval between initial diagnosis and first CNS relapse was 8 months (IQR 5.55-10.61/range 1.31-130.69). The 5-year cumulative risk of CNS relapse was 4% (95% CI 2.9-5.5). Bone marrow involvement, peripheral blasts and CNS involvement at diagnosis were more frequent in patients with CNS relapse than in patients with no relapse or with relapse with no CNS involvement. The treatment of CNS relapse was heterogeneous. The median survival after CNS relapse was 23.7 months. Eleven patients were alive at last follow-up. Three-year overall survival after CNS relapse was 48.70% (95% CI 30.52-67.23).
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Affiliation(s)
- Giada Del Baldo
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Center, Paris-Saclay University, Villejuif, France.,Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Rachid Abbas
- UVSQ, CESP, INSERM, Université Paris-Saclay, Université Paris-Sud, Villejuif, France
| | - Wilhelm Woessmann
- Department of Paediatric Haematology and Oncology, University Hospital, Hamburg-Eppendorf, Germany
| | - Keizo Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Aichi, Japan
| | - Marta Pillon
- Department of Women's and Children's Health, Paediatric Haemato-Oncology, University Hospital of Padova, Padova, Italy
| | - Amos Burke
- Department of Paediatric Haematology, Oncology and Palliative Care, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Auke Beishuizen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Charlotte Rigaud
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Center, Paris-Saclay University, Villejuif, France
| | - Marie-Cécile Le Deley
- UVSQ, CESP, INSERM, Université Paris-Saclay, Université Paris-Sud, Villejuif, France.,Department of Methodology and Biostatistics, Centre Oscar Lambret, Lille, France
| | - Laurence Lamant
- Department of Pathology, Institut Universitaire du Cancer-Oncopole, Toulouse, France
| | - Laurence Brugières
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Center, Paris-Saclay University, Villejuif, France
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21
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André N, Orbach D, Pasquier E. Metronomic Maintenance for High-Risk Pediatric Malignancies: One Size Will Not Fit All. Trends Cancer 2020; 6:819-828. [PMID: 32601045 DOI: 10.1016/j.trecan.2020.05.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/15/2020] [Accepted: 05/19/2020] [Indexed: 02/07/2023]
Abstract
Maintenance therapy sometimes relies on the use of metronomic chemotherapy (MC); that is, the continuous administration of low-dose chemotherapy. Maintenance therapy has been successfully used for decades in pediatric patients with acute lymphoblastic leukemia (ALL) and recent results have demonstrated improved outcomes in patients with pediatric high-risk rhabdomyosarcoma (RMS) on maintenance therapy. Here, we review the use of metronomic maintenance therapy in pediatric cancer and discuss its mechanisms of action on the tumor microenvironment and cancer cells. We also discuss its potential use as a chemotherapy alone or in combination with targeted therapies, immunotherapies, or agents for drug repurposing.
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Affiliation(s)
- Nicolas André
- Pediatric Hematology and Oncology Department, Hôpital pour Enfant de La Timone, AP-HM, Marseille, France; Centre de Recherche en Cancérologie de Marseille Inserm U1068, Aix-Marseille University, Marseille, France; Metronomics Global Health Initiative, Marseille, France.
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | - Eddy Pasquier
- Centre de Recherche en Cancérologie de Marseille Inserm U1068, Aix-Marseille University, Marseille, France; Metronomics Global Health Initiative, Marseille, France
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22
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Abstract
Anaplastic large cell lymphomas are a rare subtype of peripheral/mature T-cell lymphomas which are clinically, pathologically and genetically heterogeneous. Both ALK-positive (ALK+) and ALK-negative (ALK-) ALCL are composed of large lymphoid cells with abundant cytoplasm and pleomorphic features with horseshoe-shaped and reniform nuclei. ALK+ ALCL were considered as a definite entity in the 2008 World Health Organization classification of hematopoietic and lymphoid tissues. ALK-ALCL was included as a provisional entity in the WHO 2008 edition and in the most recent 2017 edition, it is now considered a distinct entity that includes cytogenetic subsets that appear to have prognostic implications (e.g. 6p25 rearrangements at IRF4/DUSP22 locus). ALK+ ALCLs are distinct in epidemiology and pathogenetic origin and should be distinguished from ALK-ALCL, cutaneous ALCL and breast implant associated ALCL which have distinct clinical course and pathogenetic features. Breast implant-associated ALCL is now recognized as a new provisional entity distinct from other ALK-ALCL; notably that it is a noninvasive disease associated with excellent outcome. In this article, we will provide an overview of the salient themes relevant to the pathology and genetic mechanisms in ALCL.
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Affiliation(s)
- Vasiliki Leventaki
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Siddharth Bhattacharyya
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA United States
| | - Megan S Lim
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA United States.
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23
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Vijayasekharan K, Prasad M, Pradhan ND, Phillip D, Gujral S, Shet T, Sridhar E, Kembhavi S, Shah S, Banavali SD, Narula G. Favorable outcomes and reduced toxicity with a novel vinblastine-based non-high dose methotrexate (HDMTX) regimen (modified MCP-842) in pediatric anaplastic large cell lymphoma (ALCL): experience from India. Leuk Lymphoma 2019; 61:912-918. [PMID: 31774004 DOI: 10.1080/10428194.2019.1695054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Anaplastic large cell lymphoma (ALCL) is a rare form of non-Hodgkin lymphoma (NHL) in children. Most treatment regimens include high-dose methotrexate (HDMTX), which is logistically difficult to administer in resource-limited settings. We evaluated the outcomes of pediatric ALCL patients treated on a uniform protocol (Modified Multicentric Protocol, MCP-842 regimen) at our hospital between January 2005 and December 2016. Of the 68 patients who received treatment on the Modified MCP842 protocol, 46 patients are alive in remission, 11(16%) had disease progression, 9(13%) relapsed after achieving remission, and 5(7%) had treatment-related mortality (TRM). Seventeen of 20 relapsed/progressed patients subsequently expired. With a median follow-up of 55 months (range 2-165 months), the 4-year event-free survival (EFS) and overall survival (OS) are 63% (95% CI of 50-73%) and 70%(95% CI of 57-79%), respectively. An indigenous protocol using vinblastine (without HDMTX and steroids) is feasible in a resource-limited setting and achieves outcomes comparable to regimens incorporating HDMTX, with lower toxicity.
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Affiliation(s)
- Kalasekhar Vijayasekharan
- Department of Medical Oncology, Pediatric Hematolymphoid Disease Management Group, Tata Memorial Center, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Maya Prasad
- Department of Medical Oncology, Pediatric Hematolymphoid Disease Management Group, Tata Memorial Center, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Nirmalya D Pradhan
- Department of Medical Oncology, Pediatric Hematolymphoid Disease Management Group, Tata Memorial Center, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Deepa Phillip
- Department of Medical Oncology, Pediatric Hematolymphoid Disease Management Group, Tata Memorial Center, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Sumeet Gujral
- Department of Medical Oncology, Pediatric Hematolymphoid Disease Management Group, Tata Memorial Center, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Tanuja Shet
- Department of Medical Oncology, Pediatric Hematolymphoid Disease Management Group, Tata Memorial Center, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Epari Sridhar
- Department of Medical Oncology, Pediatric Hematolymphoid Disease Management Group, Tata Memorial Center, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Seema Kembhavi
- Department of Medical Oncology, Pediatric Hematolymphoid Disease Management Group, Tata Memorial Center, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Sneha Shah
- Department of Medical Oncology, Pediatric Hematolymphoid Disease Management Group, Tata Memorial Center, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Shripad D Banavali
- Department of Medical Oncology, Pediatric Hematolymphoid Disease Management Group, Tata Memorial Center, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
| | - Gaurav Narula
- Department of Medical Oncology, Pediatric Hematolymphoid Disease Management Group, Tata Memorial Center, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
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24
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Hudson S, Wang D, Middleton F, Nevaldine BH, Naous R, Hutchison RE. Crizotinib induces apoptosis and gene expression changes in ALK+ anaplastic large cell lymphoma cell lines; brentuximab synergizes and doxorubicin antagonizes. Pediatr Blood Cancer 2018; 65:e27094. [PMID: 29697184 DOI: 10.1002/pbc.27094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 03/15/2018] [Accepted: 03/19/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) shows 60-70% event free survival with standard treatments. Targeted therapies are being tested for increased benefit and/or reduced toxicity, but interactions with standard agents are not well known. METHODS We exposed four ALCL cell lines to two targeted agents, crizotinib and brentuximab vedotin, and to two standard agents, doxorubicin and vinblastine. For each agent and combination, we measured apoptosis and expression of approximately 300 previously annotated genes of interest using targeted RNA-sequencing. An aurora kinase inhibitor, alisertib, was similarly tested for gene expression effects. RESULTS Only crizotinib, alone or in combination, showed significant effects (adjusted P < 0.05) on expression and apoptosis. One hundred and nine of 277 gene expressions showed crizotinib-associated differential expression, mostly downregulation, 62 associated with apoptosis, and 28 associated with both crizotinib and apoptosis. Doxorubicin was antagonistic with crizotinib on gene expression and apoptosis. Brentuximab was synergistic with crizotinib in apoptosis, and not antagonistic in gene expression. Vinblastine also appeared synergistic with crizotinib but did not achieve statistical significance. Alisertib did not show significant expression changes. CONCLUSIONS Our data suggest that crizotinib induces apoptosis through orderly changes in cell signaling associated with ALK inhibition. Expression effects of crizotinib and associated apoptosis are antagonized by doxorubicin, but apoptosis is synergized by brentuximab vedotin and possibly vinblastine. These findings suggest that concurrent use of crizotinib and doxorubicin may be counterproductive, while the pairing of crizotinib with brentuximab (or vinblastine) may increase efficacy. Alisertib did not induce expression changes at cytotoxic dosage.
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Affiliation(s)
- Sandra Hudson
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, New York
| | - Dongliang Wang
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, New York
| | - Frank Middleton
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York
| | - Barbara H Nevaldine
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, New York
| | - Rana Naous
- Department of Pathology, SUNY Upstate Medical University, Syracuse, New York
| | - Robert E Hutchison
- Department of Pathology, SUNY Upstate Medical University, Syracuse, New York
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Ruf S, Hebart H, Hjalgrim LL, Kabickova E, Lang P, Steinbach D, Schwabe GC, Woessmann W. CNS progression during vinblastine or targeted therapies for high-risk relapsed ALK-positive anaplastic large cell lymphoma: A case series. Pediatr Blood Cancer 2018. [PMID: 29512859 DOI: 10.1002/pbc.27003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Vinblastine and targeted therapies induce remissions in patients with relapsed or progressive anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL). Central nervous system (CNS) prophylaxis often is not included during re-induction in CNS-negative relapse patients. We report on five patients with progressive or early relapsed ALK-positive ALCL who developed CNS progression during re-induction with vinblastine, crizotinib, or brentuximab vedotin given for bridging to allogeneic blood stem cell transplantation. These observations suggest that CNS prophylaxis should be considered in ALCL patients suffering progression during initial therapy who receive re-induction using agents with limited CNS penetration.
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Affiliation(s)
- Stephanie Ruf
- Department of Pediatric Hematology and Oncology, Justus Liebig University Giessen, Giessen, Germany
| | - Holger Hebart
- Department of Internal Medicine, Stauferklinikum Schwaebisch Gmuend, Mutlangen, Germany
| | - Lisa Lyngsie Hjalgrim
- The Child and Youth Clinic, Department of Pediatric Hematology and Oncology, University Hospital Copenhagen, Copenhagen, Denmark
| | - Edita Kabickova
- Department of Pediatric Hematology and Oncology, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Peter Lang
- Department of Pediatric Hematology and Oncology, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Daniel Steinbach
- Department of Pediatric Hematology and Oncology, University Hospital Ulm, Ulm, Germany
| | | | - Wilhelm Woessmann
- Department of Pediatric Hematology and Oncology, Justus Liebig University Giessen, Giessen, Germany
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26
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Stadler S, Singh VK, Knörr F, Damm-Welk C, Woessmann W. Immune Response against ALK in Children with ALK-Positive Anaplastic Large Cell Lymphoma. Cancers (Basel) 2018; 10:cancers10040114. [PMID: 29642597 PMCID: PMC5923369 DOI: 10.3390/cancers10040114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/05/2018] [Accepted: 04/07/2018] [Indexed: 12/26/2022] Open
Abstract
Patients with anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) mount a humoral and cellular immune response against ALK. More than 90% of children and adolescents with ALK-positive ALCL have detectable anti-ALK antibodies in serum or plasma, and the antibody titer inversely correlates with the risk of relapse. ALK-specific CD8 and CD4 T cell responses have been described in patients with ALK-positive ALCL. Vaccination with ALK DNA led to protection against lymphoma growth in a murine model. Collectively, these data suggest that the ALK-specific immune response is involved in the control of the disease. The characteristics of the humoral and cellular immune response against ALK as well as tumor immune escape mechanisms have been increasingly investigated. However, tumor and host factors contributing to the individual immune response against ALK are still largely unknown. Depending on the individual strength of the immune response and its determinants, individualized immunological approaches might be appropriate for the consolidation of ALCL patients. Strategies such as ALK vaccination could be effective for those with a pre-existing anti-tumor immunity, while an allogeneic blood stem cell transplantation or check-point inhibition could be effective for others.
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Affiliation(s)
- Serena Stadler
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, D-35392 Giessen, Germany.
| | - Vijay Kumar Singh
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, D-35392 Giessen, Germany.
| | - Fabian Knörr
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, D-35392 Giessen, Germany.
| | - Christine Damm-Welk
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, D-35392 Giessen, Germany.
| | - Wilhelm Woessmann
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, D-35392 Giessen, Germany.
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27
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Treatment Options for Paediatric Anaplastic Large Cell Lymphoma (ALCL): Current Standard and beyond. Cancers (Basel) 2018; 10:cancers10040099. [PMID: 29601554 PMCID: PMC5923354 DOI: 10.3390/cancers10040099] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 03/26/2018] [Accepted: 03/29/2018] [Indexed: 01/22/2023] Open
Abstract
Anaplastic Lymphoma Kinase (ALK)-positive Anaplastic Large Cell Lymphoma (ALCL), remains one of the most curable cancers in the paediatric setting; multi-agent chemotherapy cures approximately 65–90% of patients. Over the last two decades, major efforts have focused on improving the survival rate by intensification of combination chemotherapy regimens and employing stem cell transplantation for chemotherapy-resistant patients. More recently, several new and ‘renewed’ agents have offered the opportunity for a change in the paradigm for the management of both chemo-sensitive and chemo-resistant forms of ALCL. The development of ALK inhibitors following the identification of the EML4-ALK fusion gene in Non-Small Cell Lung Cancer (NSCLC) has opened new possibilities for ALK-positive ALCL. The uniform expression of CD30 on the cell surface of ALCL has given the opportunity for anti-CD30 antibody therapy. The re-evaluation of vinblastine, which has shown remarkable activity as a single agent even in the face of relapsed disease, has led to the consideration of a revised approach to frontline therapy. The advent of immune therapies such as checkpoint inhibition has provided another option for the treatment of ALCL. In fact, the number of potential new agents now presents a real challenge to the clinical community that must prioritise those thought to offer the most promise for the future. In this review, we will focus on the current status of paediatric ALCL therapy, explore how new and ‘renewed’ agents are re-shaping the therapeutic landscape for ALCL, and identify the strategies being employed in the next generation of clinical trials.
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28
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29
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Al-Ahmad S, Maertens V, Libeer C, Schelfhout V, Vanhoenacker F, Boeckx N, Vandevenne M. The masquerading presentation of a systemic anaplastic large cell lymphoma, ALK positive: a case report and review of the literature. Acta Clin Belg 2017; 72:454-460. [PMID: 28441913 DOI: 10.1080/17843286.2017.1312057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We report an unusual case of systemic anaplastic large cell lymphoma (ALCL), ALK positive with leukemic involvement in a 57-year-old woman. The patient presented with a fulminant respiratory infection unresponsive to treatment requiring intensive care and ventilatory support. The CT scan demonstrated mediastinal and bilateral lymphadenopathy. On peripheral smear a few atypical lymphocytes were visualized. Based on the increasing number of atypical lymphocytes in the daily peripheral bloodsmears, the diagnosis ALCL was suggested. Definitive diagnosis was made on a bone marrow biopsy, with lymphocytes being immunoreactive for CD30, EMA, and ALK. Leukemic peripheral blood involvement in ALCL is an uncommon clinicopathologic entity with unfavorable prognosis. The case we present is perhaps unusual in that a complete respons was achieved, highlighting the importance of prompt diagnosis and judicious management.
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Affiliation(s)
| | - Vincent Maertens
- Department of Hematology, AZ Sint Maarten, Mechelen-Duffel, Belgium
| | | | - Vera Schelfhout
- Department of Pathology, AZ Sint Maarten, Mechelen-Duffel, Belgium
| | | | - Nancy Boeckx
- Department of Laboratory Medicine, UZ Leuven, Leuven, Belgium
| | - Marleen Vandevenne
- Department of Laboratory Medicine, AZ Sint Maarten, Mechelen-Duffel, Belgium
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30
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Hu L, Zhang X, Wang J, Wang S, Amin HM, Shi P. Involvement of oncogenic tyrosine kinase NPM-ALK in trifluoperazine-induced cell cycle arrest and apoptosis in ALK+ anaplastic large cell lymphoma. Hematology 2017; 23:284-290. [DOI: 10.1080/10245332.2017.1396045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Linlin Hu
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai, People’s Republic of China
- Key Laboratory of Organofluorine Chemistry, Chinese Academy of Sciences, Shanghai Institute of Organic Chemistry, Shanghai, People’s Republic of China
| | - Xiaonan Zhang
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai, People’s Republic of China
| | - Jian Wang
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai, People’s Republic of China
| | - Song Wang
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai, People’s Republic of China
| | - Hesham M. Amin
- Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Ping Shi
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai, People’s Republic of China
- Key Laboratory of Organofluorine Chemistry, Chinese Academy of Sciences, Shanghai Institute of Organic Chemistry, Shanghai, People’s Republic of China
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31
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Shelikhova LN, Fominykh VV, Abramov DS, Myakova NV, Maschan MA, Maschan AA. [Use of crizotinib for refractory ALK-positive lymphomas]. TERAPEVT ARKH 2017; 89:51-56. [PMID: 28766541 DOI: 10.17116/terarkh201789751-56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM To evaluate the safety and efficacy of crizotinib used in pediatric patients with relapsed or refractory ALK-positive anaplastic large-cell lymphoma (ALCL). SUBJECTS AND METHODS The paper describes the experience with crizotinib used in 8 patients with refractory ALK-ALCL before and after allogeneic hematopoietic stem cell transplantation (HSCT). RESULTS All the 8 (100%) patients treated with crizotinib were recorded to have complete responses, including complete metabolic ones (tumor disappearance as evidenced by positron emission tomography (PET)/computed tomography. CONCLUSION Low and manageable toxicity of crizotinib and complete PET-negative responses in patients with resistant ALK lymphomas favor the need to test the drug as first-line therapy, by possibly decreasing the intensification of chemotherapy.
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Affiliation(s)
- L N Shelikhova
- Dmitry Rogachev Federal Research and Practical Center of Pediatric Hematology, Oncology, and Immunology, Ministry of Health of Russia, Moscow, Russia
| | - V V Fominykh
- Dmitry Rogachev Federal Research and Practical Center of Pediatric Hematology, Oncology, and Immunology, Ministry of Health of Russia, Moscow, Russia
| | - D S Abramov
- Dmitry Rogachev Federal Research and Practical Center of Pediatric Hematology, Oncology, and Immunology, Ministry of Health of Russia, Moscow, Russia
| | - N V Myakova
- Dmitry Rogachev Federal Research and Practical Center of Pediatric Hematology, Oncology, and Immunology, Ministry of Health of Russia, Moscow, Russia
| | - M A Maschan
- Dmitry Rogachev Federal Research and Practical Center of Pediatric Hematology, Oncology, and Immunology, Ministry of Health of Russia, Moscow, Russia
| | - A A Maschan
- Dmitry Rogachev Federal Research and Practical Center of Pediatric Hematology, Oncology, and Immunology, Ministry of Health of Russia, Moscow, Russia
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32
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Hazar V, Kesik V, Karasu GT, Öztürk G, Küpesiz A, Kılıç SÇ, Ataş E, Uygun V, Eker N, Erbey F, Bengoa ŞY, Emir S, Anak S, Öniz H, Daloğlu H, Aksoylar S, Koçak Ü, Karakükçü M, Elli M, Kurucu N, Yeşilipek A. Risk factors predicting the survival of pediatric patients with relapsed/refractory non-Hodgkin lymphoma who underwent hematopoietic stem cell transplantation: a retrospective study from the Turkish pediatric bone marrow transplantation registry. Leuk Lymphoma 2017; 59:85-96. [DOI: 10.1080/10428194.2017.1330472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Volkan Hazar
- Departments of Pediatric Hematology and Oncology and BMT Unit, Medical Park Göztepe Hospital, Istanbul, Turkey
| | - Vural Kesik
- Gülhane Military Medical Academy, Ankara, Turkey
| | - Gülsün Tezcan Karasu
- Faculty of Medicine, Göztepe Medical Park Hospital, Bahçeşehir University, Istanbul, Turkey
| | - Gülyüz Öztürk
- Faculty of Medicine, Acıbadem Atakent Hospital, Acıbadem University Istanbul, Turkey
| | - Alphan Küpesiz
- Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Suar Çakı Kılıç
- Faculty of Medicine, Göztepe Medical Park Hospital, Bahçeşehir University, Istanbul, Turkey
| | - Erman Ataş
- Gülhane Military Medical Academy, Ankara, Turkey
| | - Vedat Uygun
- Faculty of Medicine, Antalya Medical Park Hospital, Bahçeşehir University, Antalya, Turkey
| | - Nurşah Eker
- Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Fatih Erbey
- Faculty of Medicine, Acıbadem Atakent Hospital, Acıbadem University Istanbul, Turkey
| | | | - Suna Emir
- Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Sema Anak
- Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Haldun Öniz
- Tepecik Training and Research Hospital, Izmir, Turkey
| | - Hayriye Daloğlu
- Faculty of Medicine, Antalya Medical Park Hospital, Bahçeşehir University, Antalya, Turkey
| | | | - Ülker Koçak
- Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Musa Karakükçü
- Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Murat Elli
- Faculty of Medicine, On Dokuz Mayıs University, Samsun, Turkey
| | - Nilgün Kurucu
- Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Akif Yeşilipek
- Faculty of Medicine, Göztepe Medical Park Hospital, Bahçeşehir University, Istanbul, Turkey
- Turkish Pediatric BMT Study Group, Istanbul, Turkey
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Thacker N, Bakhshi S, Chinnaswamy G, Vora T, Prasad M, Bansal D, Agarwala S, Kapoor G, Radhakrishnan V, Laskar S, Kaur T, Rath GK, Dhaliwal RS, Arora B. Management of Non-Hodgkin Lymphoma: ICMR Consensus Document. Indian J Pediatr 2017; 84:382-392. [PMID: 28378140 DOI: 10.1007/s12098-017-2318-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/10/2017] [Indexed: 12/25/2022]
Abstract
Hitherto poor outcomes, paucity of data and heterogeneity in International approach to Pediatric NHL (Non-Hodgkin Lymphoma) prompted the need for guidelines for Indian population with vast variability in access, affordability and infrastructure across the country. These guidelines are based on consensus among the experts and best available evidence applicable to Indian setting. Evaluation of NHL should consist of easily doable and rapid tissue diagnosis (biopsy or flow cytometry of peripheral blood/malignant effusions), St Jude/IPNHLSS (International Pediatric Non-Hodgkin Lymphoma Staging System) and risk grouping with CSF (Cerebro-spinal fluid), bone marrow, whole body imaging [CECT (Contrast enhanced computerized tomography) ± MRI (Magnetic resonance imaging)] and blood investigations for LDH (Lactate dehydrogenase), TLS (Tumor lysis syndrome) and organ functions. Life threatening complications like SVCS (Superior vena cava syndrome)/Mediastinal syndrome and TLS need to pre-empted and promptly managed. All children with poor general condition, co-morbidities, metabolic or obstructive complications should receive a steroid or chemotherapy pro-phase first. For mature B-NHL (B cell - Non-Hodgkin lymphoma), in centres with good infrastructure and methotrexate levels, FAB-LMB-96 (French-American-British/Lymphomes Malins B) or BFM (Berlin-Frankfurt-Münster)-NHL-95 protocols may be used. In centres with limited infrastructure and/or no methotrexate levels; CHOP (Cyclophosphamide-hydroxydaunomycin-oncovin-prednisolone) (early stage) or MCP (Multi-centre protocol)-842 [all stages except CNS (Central nervous system) disease] may be used. Patients with poor early response should have escalated therapy. High-Risk B-NHL will benefit with addition of Rituximab to standard chemotherapy. Radiotherapy (RT) is not warranted. For lymphoblastic lymphoma, in centres with good infrastructure and methotrexate levels, BFM-95 protocol may be used. In centres with limited infrastructure and/or no methotrexate levels; modified MCP-841 with cytarabine, modified BFM-90 protocol with reduced-dose methotrexate or I-BFM 2009 protocol using Capizzi methotrexate may be considered. For ALCL (Anaplastic large cell lymphoma), in centres with good infrastructure and methotrexate levels, ALCL-99 protocol may be considered. In centres with limited infrastructure and/or no methotrexate levels; CHOP (limited-stage only), modified MCP-842 protocol or APO (Adriamycin-prednisolone-oncovin) regimen may be used.
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Affiliation(s)
- Nirav Thacker
- Department of Pediatric Oncology, Tata Memorial Hospital, Parel, Mumbai, 400012, India
| | - Sameer Bakhshi
- Department of Medical Oncology, Dr. B.R.A Institute-Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Girish Chinnaswamy
- Department of Pediatric Oncology, Tata Memorial Hospital, Parel, Mumbai, 400012, India
| | - Tushar Vora
- Department of Pediatric Oncology, Tata Memorial Hospital, Parel, Mumbai, 400012, India
| | - Maya Prasad
- Department of Pediatric Oncology, Tata Memorial Hospital, Parel, Mumbai, 400012, India
| | - Deepak Bansal
- Pediatric Hematology Oncology Unit, Department of Pediatrics, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Agarwala
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Gauri Kapoor
- Department of Pediatric Hematology & Oncology, Rajiv Gandhi Cancer Institute and Research Center, Delhi, India
| | - Venkatraman Radhakrishnan
- Department of Medical Oncology and Pediatric Oncology, Cancer Institute (W.I.A), Adyar, Chennai, India
| | - Siddharth Laskar
- Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, India
| | - Tanvir Kaur
- NCD Division, Indian Council of Medical Research (ICMR), New Delhi, India
| | - G K Rath
- Dr. B.R.A Institute-Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | | | - Brijesh Arora
- Department of Pediatric Oncology, Tata Memorial Hospital, Parel, Mumbai, 400012, India.
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Kim JE, Oh EH, Ro YS, Ko JY. CD30-Positive Anaplastic Lymphoma Kinase-Negative Systemic Anaplastic Large-Cell Lymphoma in a 9-Year-Old Boy. Ann Dermatol 2016; 28:371-4. [PMID: 27274637 PMCID: PMC4884715 DOI: 10.5021/ad.2016.28.3.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 12/31/2015] [Accepted: 01/07/2016] [Indexed: 12/02/2022] Open
Abstract
Anaplastic large-cell lymphoma (ALCL) is a CD30-positive T-cell/null-cell lymphoma that is clinically classified into either primary cutaneous ALCL or systemic ALCL (S-ALCL) sub-types. Because 90% of childhood S-ALCL cases are anaplastic lymphoma kinase (ALK)-positive, there is a lack of data on ALK-negative S-ALCL cases among pediatric patients. Herein, we report a rare case of ALK-negative S-ALCL in a 9-year-old Korean boy who initially presented with itchy erythematous maculopapules and an erosive nodule on the trunk area. We emphasize the need of high index of suspicion of an underlying malignant disease in the presence of refractory eczematous lesions.
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Affiliation(s)
- Jeong Eun Kim
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Eui Hyun Oh
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Young Suck Ro
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
| | - Joo Yeon Ko
- Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea
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35
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Lenz JA, Robat CS, Stein TJ. Vinblastine as a second rescue for the treatment of canine multicentric lymphoma in 39 cases (2005 to 2014). J Small Anim Pract 2016; 57:429-34. [DOI: 10.1111/jsap.12500] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 02/17/2016] [Accepted: 02/22/2016] [Indexed: 12/26/2022]
Affiliation(s)
- J. A. Lenz
- Department of Medical Sciences, School of Veterinary MedicineUniversity of Wisconsin 2015 Linden Drive Madison WI 53706 USA
| | - C. S. Robat
- Department of Medical Sciences, School of Veterinary MedicineUniversity of Wisconsin 2015 Linden Drive Madison WI 53706 USA
| | - T. J. Stein
- Department of Medical Sciences, School of Veterinary MedicineUniversity of Wisconsin 2015 Linden Drive Madison WI 53706 USA
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36
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Hochberg J, El-Mallawany NK, Abla O. Adolescent and young adult non-Hodgkin lymphoma. Br J Haematol 2016; 173:637-50. [PMID: 27071675 DOI: 10.1111/bjh.14074] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Non-Hodgkin lymphoma (NHL) is a heterogeneous group of lymphoid malignancies accounting for a significant portion of cancers occurring in children, adolescents and young adults with an increasing incidence with age. The adolescent and young adult (AYA) population presents a specific set of characteristics and challenges. The most common diseases occurring in adolescents and young adults include Burkitt lymphoma, lymphoblastic lymphoma, diffuse large B-cell lymphoma, anaplastic large cell lymphoma and primary mediastinal B-cell lymphoma. There is also a higher incidence of primary central nervous system lymphoma in AYA patients. Cure rates largely depend on risk-stratification, and are generally superior to outcomes in comparison to older adult data but less than in younger children. Here, we review the unique clinical and biological characteristics of NHL occurring in the AYA population with a focus on how to achieve similar curative outcomes in AYA that have been established in younger cohorts.
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Affiliation(s)
- Jessica Hochberg
- Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | | | - Oussama Abla
- Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada
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37
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Turner SD, Lamant L, Kenner L, Brugières L. Anaplastic large cell lymphoma in paediatric and young adult patients. Br J Haematol 2016; 173:560-72. [PMID: 26913827 DOI: 10.1111/bjh.13958] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Anaplastic large cell lymphoma (ALCL) is a heterogeneous disease of debateable origin that, in children, is largely anaplastic lymphoma kinase (ALK) positive with aberrant ALK activity induced following the formation of chromosomal translocations. Whilst the survival rates for this disease are relatively high, a significant proportion (20-40%) of patients suffer disease relapse, in some cases on multiple occasions and therefore suffer the toxic side-effects of combination chemotherapy. Traditionally, patients are treated with a combination of agents although recent data from relapse patients have suggested that low risk patients might benefit from single agent vinblastine and, going forward, the addition of ALK inhibitors to the therapeutic regimen may have beneficial consequences. There are also a plethora of other drugs that might be advantageous to patients with ALCL and many of these have been identified through laboratory research although the decision as to which drugs to implement in trials will not be trivial.
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Affiliation(s)
- Suzanne D Turner
- Department of Pathology, Division of Molecular Histopathology, University of Cambridge, Cambridge, UK.,European Research Initiative for ALK related Malignancies, Toulouse, France
| | - Laurence Lamant
- European Research Initiative for ALK related Malignancies, Toulouse, France.,Institut Universitaire de Cancérologie Oncopole, Toulouse, France
| | - Lukas Kenner
- European Research Initiative for ALK related Malignancies, Toulouse, France.,Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Cancer Research (LBI-CR), Vienna, Austria.,Department of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Laurence Brugières
- European Research Initiative for ALK related Malignancies, Toulouse, France.,Département de Cancérologie de l'Enfant et l'Adolescent, Gustave Roussy, Villejuif, France
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38
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Minard-Colin V, Brugières L, Reiter A, Cairo MS, Gross TG, Woessmann W, Burkhardt B, Sandlund JT, Williams D, Pillon M, Horibe K, Auperin A, Le Deley MC, Zimmerman M, Perkins SL, Raphael M, Lamant L, Klapper W, Mussolin L, Poirel HA, Macintyre E, Damm-Welk C, Rosolen A, Patte C. Non-Hodgkin Lymphoma in Children and Adolescents: Progress Through Effective Collaboration, Current Knowledge, and Challenges Ahead. J Clin Oncol 2015; 33:2963-74. [PMID: 26304908 PMCID: PMC4979194 DOI: 10.1200/jco.2014.59.5827] [Citation(s) in RCA: 159] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Non-Hodgkin lymphoma is the fourth most common malignancy in children, has an even higher incidence in adolescents, and is primarily represented by only a few histologic subtypes. Dramatic progress has been achieved, with survival rates exceeding 80%, in large part because of a better understanding of the biology of the different subtypes and national and international collaborations. Most patients with Burkitt lymphoma and diffuse large B-cell lymphoma are cured with short intensive pulse chemotherapy containing cyclophosphamide, cytarabine, and high-dose methotrexate. The benefit of the addition of rituximab has not been established except in the case of primary mediastinal B-cell lymphoma. Lymphoblastic lymphoma is treated with intensive, semi-continuous, longer leukemia-derived protocols. Relapses in B-cell and lymphoblastic lymphomas are rare and infrequently curable, even with intensive approaches. Event-free survival rates of approximately 75% have been achieved in anaplastic large-cell lymphomas with various regimens that generally include a short intensive B-like regimen. Immunity seems to play an important role in prognosis and needs further exploration to determine its therapeutic application. ALK inhibitor therapeutic approaches are currently under investigation. For all pediatric lymphomas, the intensity of induction/consolidation therapy correlates with acute toxicities, but because of low cumulative doses of anthracyclines and alkylating agents, minimal or no long-term toxicity is expected. Challenges that remain include defining the value of prognostic factors, such as early response on positron emission tomography/computed tomography and minimal disseminated and residual disease, using new biologic technologies to improve risk stratification, and developing innovative therapies, both in the first-line setting and for relapse.
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Affiliation(s)
- Véronique Minard-Colin
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Laurence Brugières
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Alfred Reiter
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Mitchell S Cairo
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Thomas G Gross
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Wilhelm Woessmann
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Birgit Burkhardt
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - John T Sandlund
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Denise Williams
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Marta Pillon
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Keizo Horibe
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Anne Auperin
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Marie-Cécile Le Deley
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Martin Zimmerman
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Sherrie L Perkins
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Martine Raphael
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Laurence Lamant
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Wolfram Klapper
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Lara Mussolin
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Hélène A Poirel
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Elizabeth Macintyre
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Christine Damm-Welk
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Angelo Rosolen
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels
| | - Catherine Patte
- Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels.
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Campos-Quintero A, Patiño-Bahena E, Sánchez-Flores A, Benita-Bordes A, Aranda-Fraustro A, Buendía-Hernández A. [Primary cardiac lymphoma, a extremely rare presentation]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2015; 86:94-6. [PMID: 26232320 DOI: 10.1016/j.acmx.2015.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 06/16/2015] [Accepted: 06/23/2015] [Indexed: 11/30/2022] Open
Affiliation(s)
- Aldo Campos-Quintero
- Departamento de Cardiología Pediátrica, Instituto Nacional de Cardiología Ignacio Chávez, México, México
| | - Emilia Patiño-Bahena
- Departamento de Cardiología Pediátrica, Instituto Nacional de Cardiología Ignacio Chávez, México, México.
| | - Adrián Sánchez-Flores
- Departamento de Cardiología Pediátrica, Instituto Nacional de Cardiología Ignacio Chávez, México, México
| | - Antonio Benita-Bordes
- Departamento de Cirugía de Malformaciones Congénitas del Corazón, Instituto Nacional de Cardiología Ignacio Chávez, México, México
| | | | - Alfonso Buendía-Hernández
- Departamento de Cardiología Pediátrica, Instituto Nacional de Cardiología Ignacio Chávez, México, México
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Miyagaki S, Imamura T, Okumura Y, Ito I, Fujiki A, Osone S, Ishida H, Hosoi H. Successful treatment of relapsed anaplastic large cell lymphoma with vinblastine monotherapy and allo-HSCT with reduced intensity conditioning regimen. Pediatr Int 2015; 57:791-4. [PMID: 25847601 DOI: 10.1111/ped.12643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 12/24/2014] [Accepted: 01/15/2015] [Indexed: 11/27/2022]
Abstract
Relapsed anaplastic large cell lymphoma (ALCL) is chemosensitive, but recurrence is common. Although vinblastine (VLB) monotherapy is an effective treatment for relapsed ALCL, the optimal treatment duration is unknown, and some patients experience further relapse after completing the treatment. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is also an effective treatment for relapsed ALCL, although transplant-related toxicity is a problem. Here, we report an 11-year-old patient with relapsed ALCL who underwent induction therapy with VLB monotherapy and achieved complete remission (CR) after 12 courses. CR was confirmed on positron emission tomography-computed tomography. The patient then underwent allo-HSCT with reduced intensity conditioning (fludarabine, melphalan, and low-dose total body irradiation). He developed grade II acute graft-versus-host disease (GVHD), which was successfully treated with methylprednisolone. There was no evidence of chronic GVHD. He has remained in CR without any complications for 19 months after allo-HSCT.
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Affiliation(s)
- Satoshi Miyagaki
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto
| | - Toshihiko Imamura
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto
| | - Yoshiki Okumura
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto
| | - Ikuyo Ito
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto
| | - Atsushi Fujiki
- Department of Pediatrics, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Shinya Osone
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto
| | - Hiroyuki Ishida
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto.,Department of Pediatrics, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Hajime Hosoi
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto
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George SK, Vishwamitra D, Manshouri R, Shi P, Amin HM. The ALK inhibitor ASP3026 eradicates NPM-ALK⁺ T-cell anaplastic large-cell lymphoma in vitro and in a systemic xenograft lymphoma model. Oncotarget 2015; 5:5750-63. [PMID: 25026277 PMCID: PMC4170597 DOI: 10.18632/oncotarget.2170] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
NPM-ALK⁺ T-cell anaplastic large-cell lymphoma (ALCL) is an aggressive type of cancer. Standard treatment of NPM-ALK⁺ ALCL is CHOP polychemotherapy. Although patients initially respond favorably to CHOP, resistance, relapse, and death frequently occur. Recently, selective targeting of ALK has emerged as an alternative therapeutic strategy. ASP3026 is a second-generation ALK inhibitor that can overcome crizotinib resistance in non-small cell lung cancer, and is currently being evaluated in clinical trials of patients with ALK⁺ solid tumors. However, NPM-ALK⁺ ALCL patients are not included in these trials. We studied the effects of ASP3026 on NPM-ALK⁺ ALCL cell lines in vitro and on systemic lymphoma growth in vivo. ASP3026 decreased the viability, proliferation, and colony formation, as well as induced apoptotic cell death of NPM-ALK⁺ ALCL cells. In addition, ASP3026 significantly reduced the proliferation of 293T cells transfected with NPM-ALK mutants that are resistant to crizotinib and downregulated tyrosine phosphorylation of these mutants. Moreover, ASP3026 abrogated systemic NPM-ALK⁺ ALCL growth in mice. Importantly, the survival of ASP3026-treated mice was superior to that of control and CHOP-treated mice. Our data suggest that ASP3026 is an effective treatment for NPM-ALK⁺ ALCL, and support the enrollment of patients with this lymphoma in the ongoing clinical trials.
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Affiliation(s)
- Suraj Konnath George
- Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; These authors contributed equally to this work
| | - Deeksha Vishwamitra
- Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; The University of Texas Graduate School of Biomedical Sciences, Houston, TX; These authors contributed equally to this work
| | - Roxsan Manshouri
- Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; The University of Texas Graduate School of Biomedical Sciences, Houston, TX
| | - Ping Shi
- State Key Laboratory of Bioreactor Engineering, East China University of Science and Technology, Shanghai, China
| | - Hesham M Amin
- Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; The University of Texas Graduate School of Biomedical Sciences, Houston, TX
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Koh KN, Im HJ, Suh JK, Lee SW, Choi ES, Seo JJ. Successful use of brentuximab vedotin for refractory anaplastic large cell lymphoma as a bridging therapy to haploidentical stem cell transplantation and maintenance therapy post-transplantation. Pediatr Blood Cancer 2015; 62:1063-5. [PMID: 25641881 DOI: 10.1002/pbc.25351] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 10/20/2014] [Indexed: 01/22/2023]
Abstract
Brentuximab vedotin (BV) is a monoclonal antibody-drug conjugate that targets CD30, and has been reported to be effective for relapsed/refractory anaplastic large cell lymphoma. We here report a patient who experienced multiple relapses after conventional chemotherapy and autologous hematopoietic stem cell transplantation (HSCT). He achieved a complete metabolic response with BV and proceeded to undergo haploidentical HSCT. After HSCT, he received three doses of BV to prevent an early relapse, and remains in remission 16 months post-transplantation. Our case suggests the potential use of BV both as a bridging therapy to allogeneic HSCT and as a maintenance therapy post-transplantation.
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Affiliation(s)
- Kyung-Nam Koh
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
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43
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Strullu M, Thomas C, Le Deley MC, Chevance A, Kanold J, Bertrand Y, Jubert C, Dalle JH, Paillard C, Baruchel A, Lamant L, Michel G, Brugières L. Hematopoietic stem cell transplantation in relapsed ALK+ anaplastic large cell lymphoma in children and adolescents: a study on behalf of the SFCE and SFGM-TC. Bone Marrow Transplant 2015; 50:795-801. [DOI: 10.1038/bmt.2015.57] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 01/18/2015] [Accepted: 01/20/2015] [Indexed: 11/09/2022]
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Alexander S, Kraveka JM, Weitzman S, Lowe E, Smith L, Lynch JC, Chang M, Kinney MC, Perkins SL, Laver J, Gross TG, Weinstein H. Advanced stage anaplastic large cell lymphoma in children and adolescents: results of ANHL0131, a randomized phase III trial of APO versus a modified regimen with vinblastine: a report from the children's oncology group. Pediatr Blood Cancer 2014; 61:2236-42. [PMID: 25156886 PMCID: PMC4682366 DOI: 10.1002/pbc.25187] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 06/25/2014] [Indexed: 01/03/2023]
Abstract
BACKGROUND Optimal therapy for children and adolescents with advanced stage anaplastic large cell lymphoma (ALCL) is unknown. ANHL0131 examined whether a maintenance regimen including vinblastine compared to the standard APO (doxorubicin, prednisone, vincristine, methotrexate, 6-mercaptopurine) regimen would result in superior event-free survival. PROCEDURE One hundred and twenty five eligible patients were enrolled. Induction was identical for both arms. Post induction patients were randomized to receive APO with vincristine every 3 weeks or a regimen that substituted vincristine with weekly vinblastine (APV). RESULTS There was no difference between the patients randomized to the APO versus APV arms in either event free survival (EFS) or overall survival (OS) (three year EFS 74% vs. 79%, P = 0.68 and three years OS of 84% vs. 86%, P = 0.87, respectively). Patients in the APV arm required dose reduction secondary to myelosuppression and had a higher incidence of neutropenia as well as infection with neutropenia compared to those in the APO arm (P < 0.001, P = 0.019, respectively). CONCLUSIONS Treatment with weekly vinblastine instead of every three week vincristine as part of multi-agent maintenance therapy did not result in improvement in EFS or OS. Weekly vinblastine was associated with increased toxicity. (ClinicalTrials.gov Identifier NCT00059839).
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Affiliation(s)
- Sarah Alexander
- Division of Pediatric Hematology-Oncology, Hospital for Sick Children, Toronto, Ontario
| | - Jacqueline M Kraveka
- Division of Pediatric Hematology-Oncology, Medical University of South Carolina, Charleston, South Carolina
| | - Sheila Weitzman
- Division of Pediatric Hematology-Oncology, Hospital for Sick Children, Toronto, Ontario
| | - Eric Lowe
- Division of Pediatric Hematology/Oncology, Children’s Hospital of the King’s Daughters, Norfolk, VA
| | - Lynette Smith
- COG Data Center and University of Nebraska Medical Center, Omaha, Nebraska
| | - James C Lynch
- COG Data Center and University of Nebraska Medical Center, Omaha, Nebraska
| | - Myron Chang
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Marsha C. Kinney
- Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Sherrie L. Perkins
- Department of Pathology, University of Utah Health Sciences and ARUP Institute, Salt Lake City, Utah
| | - Joseph Laver
- St. Jude Children's Research Hospital Memphis, Memphis, Tennessee
| | - Thomas G. Gross
- Department of Pediatric Hematology-Oncology, Nationwide Children's Hospital, Columbus, Ohio
| | - Howard Weinstein
- Division of Pediatric Hematology-Oncology, Massachusetts General Hospital, Boston, Massachusetts
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Fukano R, Mori T, Kobayashi R, Mitsui T, Fujita N, Iwasaki F, Suzumiya J, Chin M, Goto H, Takahashi Y, Hara J, Park YD, Inoue M, Koga Y, Inagaki J, Sakamaki H, Adachi S, Kawa K, Kato K, Suzuki R. Haematopoietic stem cell transplantation for relapsed or refractory anaplastic large cell lymphoma: a study of children and adolescents in Japan. Br J Haematol 2014; 168:557-63. [PMID: 25312752 DOI: 10.1111/bjh.13167] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 09/04/2014] [Indexed: 11/29/2022]
Abstract
To evaluate haematopoietic stem cell transplantation (HSCT) in children and adolescents, we reviewed the records of 47 patients who were ≤18 years, had relapsed or refractory anaplastic large cell lymphoma, and received HSCT between 1990 and 2010. At HSCT, complete remission (CR) was less common in allogeneic HSCT recipients (n = 24) than in autologous HSCT recipients (n = 23) (P = 0·01). The autologous and allogeneic HSCT groups differed in terms of 5-year event-free survival (EFS) (38% vs. 50%, P = 0·63), cumulative incidence of progress or relapse (49% vs. 28%, P = 0·25), and treatment-related mortality (12% vs. 25%, P = 0·40). However, these differences were not significant. Patients with non-CR at autologous HSCT had a significantly lower EFS rate (14% vs. 48%, P = 0·03). Conversely, although those with non-CR at allogeneic HSCT had a lower EFS rate, this was not significant (44% vs. 63%, P = 0·26). Reduced-intensity conditioning regimens were used for three of the 16 allogeneic HSCTs received by patients with non-CR. These three patients achieved CR, surviving 32-65 months after HSCT. These results demonstrated that allogeneic HSCT might be a treatment option for patients who do not achieve CR through conventional chemotherapy.
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Affiliation(s)
- Reiji Fukano
- Department of Paediatrics, National Kyushu Cancer Centre, Fukuoka, Japan
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Eyre TA, Khan D, Hall GW, Collins GP. Anaplastic lymphoma kinase-positive anaplastic large cell lymphoma: current and future perspectives in adult and paediatric disease. Eur J Haematol 2014; 93:455-68. [PMID: 24766435 DOI: 10.1111/ejh.12360] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2014] [Indexed: 02/02/2023]
Abstract
Anaplastic large cell lymphoma (ALCL) is a rare T-cell lymphoma seen in both adults and children. ALCL is associated with a characteristic chromosomal translocation, t(2;5)(p23;35) which fuses the anaplastic lymphoma kinase (ALK) gene on chromosome 2 with the nucleophosmin (NPM) gene on chromosome 5, resulting in a NPM-ALK fusion protein, ALK over-expression and constitutive tyrosine kinase activity. This aggressive lymphoma is more prevalent in males and can present with extranodal involvement (lung, skin and marrow infiltration) and haemophagocytic lymphohistocytosis. The long-term overall survival is approximately 70-90% in children and over 70% in adults. Staging systems and prognostic risk factors are different in both childhood and adult ALCL. Treatment in adults is typically anthracycline-based, with autologous stem cell transplantation (ASCT) salvaging patients in relapsed disease. There is evidence for ALL-like therapy or intensive, pulsed anthracycline-based induction in children. ASCT, allogeneic SCT and vinblastine maintenance are all considered reasonable options in relapsed childhood disease. The anti-CD30 immunoconjugate Brentuximab Vedotin and the specific ALK inhibitor Crizotinib are changing the treatment paradigm in ALCL (ALK-positive or negative) and ALK-positive ALCL respectively. Both agents have shown encouraging responses in relapsed ALCL. It remains to be seen how these novel agents are used, but it is very possible that they may improve overall responses and survival in both children and adults. This review highlights the presentation, histopathological features, prognostic factors, and evidence-based treatment approaches in the first line and relapsed setting in ALK-positive ALCL. The review concludes by discussing the novel approaches using Brentuximab and Crizotinib which are being tested in clinical trials.
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Affiliation(s)
- Toby A Eyre
- Department of Haematology, Oxford University Hospitals NHS Trust, Churchill Hospital, Oxford, UK
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Pasqualini C, Minard-Colin V, Saada V, Lamant L, Delsol G, Patte C, Le Deley MC, Valteau-Couanet D, Brugières L. Clinical analysis and prognostic significance of haemophagocytic lymphohistiocytosis-associated anaplastic large cell lymphoma in children. Br J Haematol 2014; 165:117-125. [DOI: 10.1111/bjh.12728] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Accepted: 10/13/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Claudia Pasqualini
- Department of Paediatric Oncology; Institut Gustave Roussy; Villejuif France
| | | | - Veronique Saada
- Department of Cytopathology; Institut Gustave Roussy; Villejuif France
| | - Laurence Lamant
- Department of Pathology; CHU Toulouse; Hôpital Purpan; Toulouse France
- INSERM U563; Centre de Physiopathologie de Toulouse Purpan; Toulouse France
| | - Georges Delsol
- Department of Pathology; CHU Toulouse; Hôpital Purpan; Toulouse France
- INSERM U563; Centre de Physiopathologie de Toulouse Purpan; Toulouse France
| | - Catherine Patte
- Department of Paediatric Oncology; Institut Gustave Roussy; Villejuif France
| | - Marie-Cécile Le Deley
- Biostatistics and Epidemiology Unit; Institut Gustave Roussy; Villejuif France
- Univ Paris-Sud; Le Kremlin-Bicêtre France
| | | | - Laurence Brugières
- Department of Paediatric Oncology; Institut Gustave Roussy; Villejuif France
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48
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Giulino-Roth L, Ricafort R, Kernan NA, Small TN, Trippett TM, Steinherz PG, Prockop SE, Scaradavou A, Chiu M, O'Reilly RJ, Boulad F. Ten-year follow-up of pediatric patients with non-Hodgkin lymphoma treated with allogeneic or autologous stem cell transplantation. Pediatr Blood Cancer 2013; 60:2018-24. [PMID: 24038967 DOI: 10.1002/pbc.24722] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 07/12/2013] [Indexed: 11/07/2022]
Abstract
BACKGROUND Autologous or allogeneic hematopoietic stem cell transplant (SCT) is often considered in patients with relapsed or refractory non-Hodgkin lymphoma (NHL) but there are limited data on the use of SCT for the treatment of NHL in the pediatric setting. PROCEDURE To evaluate the role of SCT for children with NHL, we reviewed 36 consecutive pediatric patients with NHL who underwent an allogeneic (n = 21) or autologous (n = 15) SCT at our institution between 1982 and 2004. Pathologic classification included: lymphoblastic lymphoma (n = 12), Burkitt lymphoma (BL) (n = 5), diffuse large B-cell lymphoma (n = 4), anaplastic large cell lymphoma (ALCL) (n = 13), peripheral T cell lymphoma (n = 1), and undifferentiated NHL (n = 1). Donor source for allogeneic-SCT recipients was an HLA-matched related donor (n = 15), a matched unrelated donor (n = 4), or a mismatched donor (related n = 1; unrelated n = 1). Twenty-eight patients (78%) had chemotherapy responsive disease at the time of transplant (either CR or PR). RESULTS Overall survival (OS) and disease-free survival (DFS) were 55% and 53% with a median follow-up of 9.75 years. Outcomes were similar in patients receiving autologous and allogeneic-SCT (DFS 53% in both groups). Patients with ALCL had a DFS of 76.9%. In contrast, of five patients transplanted for BL, none survived. DFS among patients with chemotherapy sensitive disease was 61%, compared with 25% among patients with relapsed/refractory disease (P = 0.019). CONCLUSIONS Allogeneic and autologous SCT offer the prospect of durable, disease-free survival for a significant proportion of pediatric patients with relapsed or refractory NHL. Survival is superior among patients with chemotherapy sensitive disease.
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Affiliation(s)
- Lisa Giulino-Roth
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Pediatrics, Weill Cornell Medical College, New York, New York
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49
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Abstract
Anaplastic Large Cell Lymphoma (ALCL) is the most common mature T-cell neoplasm in children and adolescents. ALCLs comprise approximately 15% of all non-Hodgkin lymphomas (NHL) in children and adolescents and commonly present with advanced systemic disease. Dissimilar from ALCL in adults, ALCL in children is nearly universally anaplastic large cell lymphoma kinase (ALK) positive. Despite the relative rarity of the disease, a great deal of insight into the pathogenesis of ALCL has been learned by researching the essential oncogenic role of ALK. Many different treatment strategies have been utilized with similar event free survival (EFS) rates of 65-75%. This review will provide an overview of the pathology, clinical features, prognostics factors, and treatment for children and adolescents with ALK positive ALCL.
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Affiliation(s)
- Eric J Lowe
- Division of Pediatric Hematology-Oncology, Children's Hospital of the Kings Daughters, Norfolk, Virginia 25507, USA.
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50
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Woessmann W. XI. How to treat children and adolescents with relapsed non-Hodgkin lymphoma? Hematol Oncol 2013; 31 Suppl 1:64-8. [PMID: 23775653 DOI: 10.1002/hon.2069] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Wilhelm Woessmann
- Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen, Germany.
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