Prognostic Factors in Childhood Anaplastic Large Cell Lymphoma: Long Term Results of the International ALCL99 Trial

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2020 Sep 29

PMID 32987765

Citations 24

Authors

Lara Mussolin

Marie-Cecile Le Deley

Elisa Carraro

Christine Damm-Welk

Andishe Attarbaschi

Denise Williams

Amos Burke

Keizo Horibe

Atsuko Nakazawa

Grazyna Wrobel

Georg Mann

Monika Csoka

Anne Uyttebroeck

Rafael Fernandez-Delgado Fernandez-Delgado Cerda

Auke Beishuizen

Karin Mellgren

Birgit Burkhardt

Wolfram Klapper

Suzanne D Turner

Emanuele S G DAmore

Laurence Lamant

Alfred Reiter

Wilhelm Woessmann

Laurence Brugieres

Marta Pillon On Behalf Of The European Inter-Group For Childhood Non-Hodgkin Lymphoma Pillon

Affiliations

Soon will be listed here.

Abstract

With the aim of describing the long-term follow-up and to define the prognostic role of the clinical/pathological/molecular characteristics at diagnosis for childhood, adolescent and young adults affected by anaplastic large cell lymphoma (ALCL), we analyzed 420 patients aged up to 22 years homogeneously treated within the international ALCL99 trial. The 10-year progression free survival (PFS) was 70% and overall survival was 90%, rare late relapses occurred but no secondary malignancies were reported. Among clinical/pathological characteristics, only patients presenting a small cell/lymphohistiocytic (SC/LH) pattern were independently associated with risk of failure (hazard ratio = 2.49). Analysis of minimal disseminated disease (MDD), available for 162 patients, showed that both SC/LH pattern (hazard ratio = 2.4) and MDD positivity (hazard ratio = 2.15) were significantly associated with risk of failure in multivariate analysis. Considering MDD and SC/LH results, patients were separated into three biological/pathological (bp) risk groups: a high-risk group (bpHR) including MDD-positive patients with SC/LH pattern; a low-risk group (bpLR) including MDD-negative patients without SC/LH pattern; and an intermediate-risk group (bpIR) including remaining patients. The 10-year PFS was 40%, 75% and 86% for bpHR, bpIR and bpLR, respectively ( < 0.0001). These results should be considered in the design of future ALCL trials to tailor individual treatments.

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