Stratified Treatment in Pediatric Anaplastic Large Cell Lymphoma: Result of a Prospective Open-Label Multiple-Institution Study

被引：0

作者：

Chen, Tingting ^{[1
,2
]}

Zeng, Chenggong ^{[1
,2
]}

Wang, Juan ^{[1
,2
]}

Sun, Feifei ^{[1
,2
]}

Huang, Junting ^{[1
,2
]}

Zhu, Jia ^{[1
,2
]}

Lu, Suying ^{[1
,2
]}

Liao, Ning ^{[3
]}

Zhang, Xiaohong ^{[4
]}

Chen, Zaisheng ^{[5
]}

Yuan, Xiuli ^{[6
]}

Yang, Zhen ^{[7
]}

Guo, Haixia ^{[8
]}

Yang, Liangchun ^{[9
]}

Wen, Chuan ^{[10
]}

Zhang, Wenlin ^{[11
]}

Li, Yang ^{[12
]}

Luo, Xuequn

Wu, Zelin ^{[14
]}

Yang, Lihua ^{[15
]}

Liu, Riyang ^{[16
]}

Zheng, Mincui ^{[17
]}

He, Xiangling ^{[13
,18
]}

Sun, Xiaofei ^{[1
,2
]}

Zhen, Zijun ^{[1
,2
]}

机构：

[1] Sun Yat Sen Univ, Canc Ctr, Dept Pediat Oncol, State Key Lab Oncol Southern China, Guangzhou, Peoples R China

[2] Collaborat Innovat Ctr Canc Med, Guangzhou, Peoples R China

[3] Guangxi Med Univ, Affiliated Hosp 1, Nanning, Peoples R China

[4] Guangzhou Med Univ, Guangzhou Women & Childrens Med Ctr, Guangzhou, Peoples R China

[5] Fujian Med Univ, Union Hosp, Fuzhou, Peoples R China

[6] Shenzhen Childrens Hosp, Shenzhen, Peoples R China

[7] Kunming Childrens Hosp, Kunming, Peoples R China

[8] Southern Med Univ, Nanfang Hosp, Guangzhou, Peoples R China

[9] Cent South Univ, Xiangya Hosp, Changsha, Peoples R China

[10] Cent South Univ, Xiangya Hosp 2, Changsha, Hunan, Peoples R China

[11] Zhengzhou Univ, Affiliated Canc Hosp, Henan Canc Hosp, Zhengzhou, Peoples R China

[12] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Guangzhou, Peoples R China

[13] Sun Yat Sen Univ, Affiliated Hosp 1, Guangzhou, Peoples R China

[14] Guangzhou Med Univ, Affiliated Hosp 1, Guangzhou, Peoples R China

[15] Southern Med Univ, ZhuJiang Hosp, Guangzhou, Peoples R China

[16] Huizhou Cent Peoples Hosp, Huizhou Municipal Cent Hosp, Huizhou, Peoples R China

[17] Hunan Childrens Hosp, Dept Hematol, Changsha, Peoples R China

[18] First Affiliated Hosp Hunan Normal Univ, Hunan Prov Peoples Hosp, Dept Radiol, Changsha, Peoples R China

来源：

CANCER RESEARCH AND TREATMENT | 2024年 / 56卷 / 04期

关键词：

Pediatric; Anaplastic large cell lymphoma; Stage; Stratified treatment; Minimal disseminated disease; Small cell/lympho- histiocytic; MINIMAL DISSEMINATED DISEASE; NON-HODGKIN-LYMPHOMA; NPM-ALK; PROGNOSTIC IMPACT; BONE-MARROW; CHILDREN; ADOLESCENTS; CHEMOTHERAPY; THERAPY; TUMOR;

D O I：

10.4143/crt.2024.104

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose The risk stratification of pediatric anaplastic large cell lymphoma (ALCL) has not been standardized. In this study, new risk factors were included to establish a new risk stratification system for ALCL, and its feasibility in clinical practice was explored. Materials and Methods On the basis of the non-Hodgkin's lymphoma Berlin-Frankfurt-Munster 95 (NHL-BFM-95) protocol, patients with minimal disseminated disease (MDD), high-risk tumor site (multiple bone, skin, liver, and lung involvement), and small cell/ lymphohistiocytic (SC/LH) pathological subtype were enrolled in risk stratification. Patients were treated with a modified NHL-BFM-95 protocol combined with an anaplastic lymphoma kinase inhibitor or vinblastine (VBL). Results A total of 136 patients were enrolled in this study. The median age was 8.8 years. The 3-year event-free survival (EFS) and overall survival of the entire cohort were 77.7% (95% confidence interval [CI], 69.0% to 83.9%) and 92.3% (95% CI, 86.1% to 95.8%), respectively. The 3-year EFS rates of low-risk group (R1), intermediate-risk group (R2), and high-risk group (R3) patients were 100%, 89.5% (95% CI, 76.5% to 95.5%), and 67.9% (95% CI, 55.4% to 77.6%), respectively. The prognosis of patients with MDD (+), stage IV cancer, SC/LH lymphoma, and high-risk sites was poor, and the 3-year EFS rates were 45.3% (95% CI, 68.6% to 19.0%), 65.7% (95% CI, 47.6% to 78.9%), 55.7% (95% CI, 26.2% to 77.5%), and 70.7% (95% CI, 48.6% to 84.6%), respectively. At the end of follow-up, one of the five patients who received maintenance therapy with VBL relapsed, and seven patients receiving anaplastic lymphoma kinase inhibitor maintenance therapy did not experience relapse. Conclusion This study has confirmed the poor prognostic of MDD (+), high-risk site and SC/LH, but patients with SC/LH lymphoma and MDD (+) at diagnosis still need to receive better treatment (ClinicalTrials.gov number, NCT03971305).

引用

页码：1252 / 1261

页数：10

共 31 条

[1] Impact of etoposide and ASCT on survival among patients aged <65 years with stage II to IV PTCL: a population-based cohort study [J].

Brink, Mirian ;

Meeuwes, Frederik O. ;

van der Poel, Marjolein W. M. ;

Kersten, Marie Jose ;

Wondergem, Marielle ;

Mutsaers, Pim G. N. J. ;

Bohmer, Lara H. ;

Woei-A-Jin, F. J. Sherida H. ;

Visser, Otto ;

Oostvogels, Rimke ;

Jansen, Patty M. ;

Plattel, Wouter ;

Huls, Gerwin A. ;

Vermaat, Joost S. P. ;

Nijland, Marcel .

BLOOD, 2022, 140 (09) :1009-1019

[2] Impact of the Methotrexate Administration Dose on the Need for Intrathecal Treatment in Children and Adolescents With Anaplastic Large-Cell Lymphoma: Results of a Randomized Trial of the EICNHL Group [J].

Brugieres, Laurence ;

Le Deley, Marie-Cecile ;

Rosolen, Angelo ;

Williams, Denise ;

Horibe, Keizo ;

Wrobel, Grazyna ;

Mann, Georg ;

Zsiros, Jozsef ;

Uyttebroeck, Anne ;

Marky, Ildiko ;

Lamant, Laurence ;

Reiter, Alfred .

JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (06) :897-903

[3] Outcome and prognosis of anaplastic large cell lymphoma in children: a report from the Taiwan Pediatric Oncology Group [J].

Chen, Shih-Hsiang ;

Chen, Jiann-Shiuh ;

Jou, Shiann-Tarng ;

Wu, Kang-Hsi ;

Hung, Iou-Jih ;

Sheen, Jiunn-Ming ;

Lu, Meng-Yao ;

Chen, Bow-Wen ;

Jaing, Tang-Her ;

Wang, Shih-Chung ;

Lin, Ming-Tsan ;

Chang, Te-Kau ;

Liu, Hsi-Che ;

Yang, Chao-Ping .

LEUKEMIA & LYMPHOMA, 2019, 60 (08) :1942-1949

[4] Recommendations for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The Lugano Classification [J].

Cheson, Bruce D. ;

Fisher, Richard I. ;

Barrington, Sally F. ;

Cavalli, Franco ;

Schwartz, Lawrence H. ;

Zucca, Emanuele ;

Lister, T. Andrew .

JOURNAL OF CLINICAL ONCOLOGY, 2014, 32 (27) :3059-+

[5] Prognostic significance of circulating tumor cells in bone marrow or peripheral blood as detected by qualitative and quantitative PCR in pediatric NPM-ALK-positive anaplastic large-cell lymphoma [J].

Damm-Welk, Christine ;

Busch, Kerstin ;

Burkhardt, Birgit ;

Schieferstein, Jutta ;

Viehmann, Susanne ;

Oschlies, Ilske ;

Klapper, Wolfram ;

Zimmermann, Martin ;

Harbott, Jochen ;

Reiter, Alfred ;

Woessmann, Willi .

BLOOD, 2007, 110 (02) :670-677

[6] Quantification of Minimal Disease by Digital PCR in ALK-Positive Anaplastic Large Cell Lymphoma: A Step towards Risk Stratification in International Trials? [J].

Damm-Welk, Christine ;

Lovisa, Federica ;

Contarini, Giorgia ;

Luedersen, Jette ;

Carraro, Elisa ;

Knorr, Fabian ;

Foerster, Jan ;

Zimmermann, Martin ;

Sala, Alessandra ;

Vinti, Luciana ;

Tondo, Annalisa ;

Pillon, Marta ;

Woessmann, Wilhelm ;

Mussolin, Lara .

CANCERS, 2022, 14 (07)

[7] Quantification of minimal disseminated disease by quantitative polymerase chain reaction and digital polymerase chain reaction for NPM-ALK as a prognostic factor in children with anaplastic large cell lymphoma [J].

Damm-Welk, Christine ;

Kutscher, Nina ;

Zimmermann, Martin ;

Attarbaschi, Andishe ;

Schieferstein, Jutta ;

Knoerr, Fabian ;

Oschlies, Ilske ;

Klapper, Wolfram ;

Woessmann, Wilhelm .

HAEMATOLOGICA, 2020, 105 (08) :2141-2149

[8] Early assessment of minimal residual disease identifies patients at very high relapse risk in NPM-ALK-positive anaplastic large-cell lymphoma [J].

Damm-Welk, Christine ;

Mussolin, Lara ;

Zimmermann, Martin ;

Pillon, Marta ;

Klapper, Wolfram ;

Oschlies, Ilske ;

d'Amore, Emanuele S. G. ;

Reiter, Alfred ;

Woessmann, Wilhelm ;

Rosolen, Angelo .

BLOOD, 2014, 123 (03) :334-337

[9] Allogeneic haematopoietic cell transplant in patients with relapsed/refractory anaplastic large cell lymphoma [J].

Furqan, Fateeha ;

Ahn, Kwang W. ;

Chen, Yue ;

Kaur, Manmeet ;

Abutalib, Syed A. ;

Ahmed, Nausheen ;

Ahmed, Sairah ;

Kharfan-Dabaja, Mohamed A. ;

Friedberg, Johnathan ;

Gregory, Tara ;

Hill, LaQuisa ;

Sterling, Cole ;

Barta, Stephan K. ;

Shadman, Mazyar ;

Perales, Miguel-Angel ;

Zain, Jasmine ;

Herrera, Alex F. ;

Sauter, Craig ;

Hamadani, Mehdi .

BRITISH JOURNAL OF HAEMATOLOGY, 2023, 200 (01) :54-63

[10] Prognostic impact of minimal disseminated disease and immune response to NPM-ALK in Japanese children with ALK-positive anaplastic large cell lymphoma [J].

Iijima-Yamashita, Yuka ;

Mori, Tetsuya ;

Nakazawa, Atsuko ;

Fukano, Reiji ;

Takimoto, Tetsuya ;

Tsurusawa, Masahito ;

Kobayashi, Ryoji ;

Horibe, Keizo .

INTERNATIONAL JOURNAL OF HEMATOLOGY, 2018, 107 (02) :244-250

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