Abstract 1618

Background:

Anaplastic large cell lymphoma (ALCL) is a distinct type of peripheral T-cell lymphoma (PTCL) characterized histologically, by large anaplastic lymphoid cells that are CD30 positive. There is biologic heterogeneity within ALCL: ALK (anaplastic lymphoma kinase) positive cases harbor a translocation usually involving chromosomes 2 and 5 resulting in over-expression of ALK (variant translocations also occur) whereas ALK negative cases do not. ALK positive ALCL is also clinically distinctive, with a younger age of onset and better treatment outcomes. In the recent International PTCL and Natural Killer (NK) T-Cell Lymphoma Study (Savage et al. Blood.2008: 111 (12)), the outcome for patients with ALK positive compared to ALK negative ALCL was significantly better (5-year failure-free survival (FFS) 60% versus 36%: p=0.15). Methods: We prospectively investigated the efficacy of 6 cycles of DA-EPOCH chemotherapy in newly diagnosed patients with both ALK positive and ALK negative ALCL and compared their outcome to other subtypes of PTCL. Results: Clinical characteristics of 38 enrolled patients are shown below. 22 patients had a diagnosis of ALCL and other diagnoses were PTCL-NOS (10), hepatosplenic gamma delta T-cell lymphoma (4), enteropathy associated T-cell lymphoma (1) and angioimmunoblastic T-cell lymphoma (1). Patients with ALK positive and ALK negative ALCL had similar characteristics. With a median potential follow-up time of 10.5 years, the 5 year progression-free survival (PFS) probability for ALK positive versus negative patients was 80% versus 71% (p=0.82); 5 year overall survival (OS) was 86% in both groups (p=0.95). For patients with other subtypes of PTCL, PFS and OS were 32% and 50% respectively, at 5-years. Conclusions: In contrast to other reports, patients with ALK negative ALCL had a very favorable outcome following DA-EPOCH chemotherapy that was no different from that of ALK positive cases. This regimen is highly effective in ALCL, independent of ALK expression. Accrual continues.

Disclosures:

No relevant conflicts of interest to declare.

Author notes

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Asterisk with author names denotes non-ASH members.