AnaIysis of clinical characteristics and prognostic factors for systemic anaplastic large cell lymphoma

Objective\r\nTo study clinical characteristics and prognostic factors in systemic anaplastic large cell lymphoma(ALCL).\r\n\r\n\r\nMethods\r\nFrom January 2010 to January 2015, 21 systemic ALCL patients who were admitted in Department of Lymphoma, Sichuan Cancer Hospital were included in this study. All this patients were treated with cyclophosphamide, epirubicin, vincristine, and prednisone (CHOP) like chemotherapy. The overall response rate (ORR) and overall survival (OS) rate of anaplastic lymphoma kinase (ALK) positive patients were compared with that of ALK- patients. Age, sex, Eastern Cooperative Oncology Group (ECOG) score, Ann-Arbor stage, B symptoms, international prognostic index (IPI) score, lactate dehydrogenase (LDH) level, extranodal invasion were analyzed for prognosis by univariate analysis.\r\n\r\n\r\nResults\r\nIn these 21 cases patients, 18 cases (85.7%) had 0-1 ECOG score, 16 cases (76.2%) were in Ⅲ-Ⅳ Ann Arbor stage, and 12 cases (57.1%) had IPI score over 2. All of these patients had lymphadenectasis (100.0%). Eight cases (38.1%) had extranodal disease at diagnosis, 10 cases (47.6%) had B symptoms, and 10 cases (47.6%) had elevated LDH level. Thirteen cases (61.9%) were ALK+ patients, and 8 cases (38.1%) were ALK-. There were no significant differences of clinical data between ALK+ and ALK- patients (P\u003e0.05). ORR of ALCL patients with CHOP like chemotherapy was 71.4%. ORR of ALK+ patients was 92.3%, and that of ALK- patients was 37.5%. There were differences of ORR and OS rate between ALK+ and ALK- patients (P 0.05).\r\n\r\n\r\nConclusions\r\nMost patients with systemic ALCL usually have late stage, B symptoms and extranodal invasion. But patients have good response to CHOP like chemotherapy and long-term survival rate. ALK- and elevated LDH level are correlated to unfavorable prognosis.\r\n\r\n\r\nKey words: \r\nLymphoma; Lymphoma, large-cell, anaplastic; Prognosis; Anaplastic lymphoma kinase