Anaplastic large-cell lymphoma: Clinical and prognostic evaluation of 90 adult patients

P. L. Zinzani, M. Bendandi, M. Martelli, B. Falini, E. Sabattini, S. Amadori, F. Gherlinzoni, M. F. Martelli, F. Mandelli, S. Tura, S. A. Pileri

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Abstract

Purpose: During the last few years, the application of CD30 monoclonal antibodies has led to the identification of a new lymphoma entity, termed anaplastic large cell lymphoma (ALCL). This tumor includes four distinct histologic subtypes, among which the Hodgkin's-like/Hodgkin's-related one (ALCL-HL) shares morphologic and phenotypic features with Hodgkin's disease (HD). Patients and Methods: From September 1988 to October 1993, 90 ALCL patients were treated with third-generation chemotherapy regimens (either vincristine, cyclophosphamide, fluorouracil, cytarabine, doxorubicin, methotrexate with leucovorin, and prednisone [F-MA-CHOP) or methotrexate with leucovorin, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin [MACOP-B]) during the course of an Italian multicentric randomized trial on high-grade non-Hodgkin's lymphomas (HG-NHL). In particular, 47 patients had ALCL of the common type (ALCL-CT) and 43 ALCL-HL. Null phenotype was the most common (39.8%), while T-cell, B-cell, and hybrid forms accounted for 35.5%, 22.2%, and 2.5%, respectively. Results: Complete remission (CR) was achieved in 66 of 90 (73.5%) patients (33 of 47 [70%] with ALCL-CT and 33 of 43 [77%] with ALCL-HL). The majority of the patients in CR (56.5%) were alive and well at a median follow-up time of 38 months; no significant differences were observed between the two histologic groups, with the rate of complete responders being 49% and 65% in ALCL-CT and ALCL-HL, respectively. The probability of relapse-free survival (RFS), projected at 63 months, was 67% for ALCL-CT and 82% for ALCL-HL. The risk of lower CR and RFS rates was associated with the presence of bulky disease, advanced stage, and B symptoms. Conclusion: The data of the present study confirm that ALCL responds to third-generation chemotherapy regimens similarly to other aggressive malignant lymphomas in terms of both CR and RFS rates.

Original languageEnglish
Pages (from-to)955-962
Number of pages8
JournalJournal of Clinical Oncology
Volume14
Issue number3
Publication statusPublished - Mar 1996

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ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Zinzani, P. L., Bendandi, M., Martelli, M., Falini, B., Sabattini, E., Amadori, S., Gherlinzoni, F., Martelli, M. F., Mandelli, F., Tura, S., & Pileri, S. A. (1996). Anaplastic large-cell lymphoma: Clinical and prognostic evaluation of 90 adult patients. Journal of Clinical Oncology, 14(3), 955-962.