Primary Systemic Anaplastic Large Cell Lymphoma in Korean Adults: 11 Years' Experience at Asan Medical Center
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Purpose: Anaplastic large cell lymphoma (ALCL), a CD30+ T-cell non-Hodgkin's lymphoma, represents only 2-8% of lymphoma overall. Information on the clinical findings of primary systemic ALCL in Korea is limited. Our aims were to report the clinical features and outcomes of primary systemic ALCL. Patients and Methods: We retrospectively reviewed the medical records of 36 adult patients diagnosed with primary systemic ALCL at Asan Medical Center from February 1995 through June 2006. Results: Of 36 patients, 29 were male. The median age was 39 years (range, 17-67years), and 26 (72%) presented with Ann Arbor stages III and IV. The most commonly involved extranodal sites were bone (n=7) and soft tissue (n=6). Thirty-two of all patients (89%) were treated with an anthracycline-based regimen including cyclophosphamide/doxorubicin/vincristine/prednisone (CHOP) as induction chemotherapy; 16 (50%) achieved complete remission (CR), and 13 (41%) achieved partial remission (PR). Median overall survival (OS) and event-free survival (EFS) were 49 and 17 months, respectively. Univariate analysis showed that performance status (p=0.035), international prognostic index (IPI) (p=0.025), and age-adjusted IPI (p=0.034) were significant prognostic factors for OS, whereas anaplastic lymphoma kinase (ALK) expression did not affect OS (p= 0.483). Conclusion: Our retrospective analysis of Korean primary systemic ALCL patients showed that median OS was 49 months and overall response to CHOP was 91%. Performance, IPI, and age-adjusted IPI were predictors of OS, whereas ALK expression did not have prognostic significance.
Abstract
Purpose: Anaplastic large cell lymphoma (ALCL), a CD30+ T-cell non-Hodgkin's lymphoma, represents only 2-8% of lymphoma overall. Information on the clinical findings of primary systemic ALCL in Korea is limited. Our aims were to report the clinical features and outcomes of primary systemic ALCL. Patients and Methods: We retrospectively reviewed the medical records of 36 adult patients diagnosed with primary systemic ALCL at Asan Medical Center from February 1995 through June 2006. Results: Of 36 patients, 29 were male. The median age was 39 years (range, 17-67years), and 26 (72%) presented with Ann Arbor stages III and IV. The most commonly involved extranodal sites were bone (n=7) and soft tissue (n=6). Thirty-two of all patients (89%) were treated with an anthracycline-based regimen including cyclophosphamide/doxorubicin/vincristine/prednisone (CHOP) as induction chemotherapy; 16 (50%) achieved complete remission (CR), and 13 (41%) achieved partial remission (PR). Median overall survival (OS) and event-free survival (EFS) were 49 and 17 months, respectively. Univariate analysis showed that performance status (p=0.035), international prognostic index (IPI) (p=0.025), and age-adjusted IPI (p=0.034) were significant prognostic factors for OS, whereas anaplastic lymphoma kinase (ALK) expression did not affect OS (p= 0.483). Conclusion: Our retrospective analysis of Korean primary systemic ALCL patients showed that median OS was 49 months and overall response to CHOP was 91%. Performance, IPI, and age-adjusted IPI were predictors of OS, whereas ALK expression did not have prognostic significance.
참고문헌 (23)
- Tilly H, "Primary anaplastic large-cell lymphoma in adults: clinical presentation, immunophenotype, and outcome", Blood, 90, pp.3727~3734 (1997)
- Chan JK, "The new World Health Organization classification of lymphomas: the past, the present and the future", Hematol Oncol, 19, pp.129~150 (2001)
- Stein H, "The expression of the Hodgkin's disease associated antigen Ki-1 in reactive and neoplastic lymphoid tissues: evidence that Reed-Sternberg cells and histiocytic malignancies are derived from activated lymphoid cells", Blood, 66, pp.848~858 (1985)
- Falini B, "CD30 (Ki-1) molecule: a new cytokine receptor of the tumor necrosis factor receptor superfamily as a tool for diagnosis and immunotherapy", Bloo, 85, pp.1~14 (1995)
- Harris NL, "A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group", Blood, 84, pp.1361~1392 (1994)
- Stein H, "CD30(+) anaplastic large cell lymphoma: a review of its histopathologic, genetic, and clinical features", Blood, 96, pp.3681~3695 (2000)
- Mason DY, "CD30-positive large cell lymphomas ('Ki-1 lymphoma') are associated with a chromosomal translocation involving 5q35", Br J Haematol, 74, pp.161~168 (1990)
- Duyster J, "Translocations involving anaplastic lymphoma kinase (ALK)", Oncogene, 20, pp.5623~5637 (2001)
- Skinnider BF, "Anaplastic large cell lymphoma: a clinicopathologicanalysis", Hematol Oncol, 17, pp.137~148 (1999)
- Campo E, "Update on extranodal lymphomas. Conclusions of the Workshop held by the EAHP and the SH in Thessaloniki, Greece", Histopathology, 48, pp.481~504 (2006)
- Waits TM, "Effective therapy for poor-prognosis non-Hodgkin's lymphoma with 8 weeks of high-doseintensity combination chemotherapy", J Clin Oncol, 11, pp.943~949 (1993)
- Cheson BD, "Report of an international workshop to standardize response criteria for non- Hodgkin's lymphomas. NCI Sponsored International Working Group", J Clin Oncol, 17, pp.1244~1253 (1999)
- Longo G, "Clinical characteristics, treatment outcome and survival of 36 adult patients with primary anaplastic large cell lymphoma. Gruppo Italiano per lo Stufio dei Linfomi (GISL)", Haematologica, 84, pp.425~430 (1999)
- Sook Ryun Park, "Primary Systemic Anaplastic Large Cell Lymphoma in a Single Korean Institution: Clinical Characteristics and Treatment Outcome", Journal of Korean Medical Science, 21(4), pp.633~638 (2006), 대한의학회
- Lin CN, "Anaplastic large cell lymphoma--a rare disorder in Southern Taiwan", Leuk Lymphoma, 44, pp.1727~1731 (2003)
- Clavio M, "Anaplastic large cell lymphoma: a clinicopathologic study of 53 patients", Leuk Lymphoma, 22, pp.319~327 (1996)
- Au WY, "Clinicopathologic features and treatment outcome of mature T-cell and natural killer-cell lymphomas diagnosed according to the World Health Organization classification scheme: a single center experience of 10 years", Ann Oncol, 16, pp.206~214 (2005)
- ten Berge RL, "ALK-negative systemic anaplastic large cell lymphoma: differential diagnostic and prognostic aspects--a review", J Pathol, 200, pp.4~15 (2003)
- Falini B, "ALK+ lymphoma: clinico-pathological findings and outcome", Blood, 93, pp.2697~2706 (1999)
- ten Berge RL, "ALK expression in extranodal anaplastic large cell lymphoma favours systemic disease with (primary) nodal involvement and a good prognosis and occurs before dissemination", J Clin Pathol, 53, pp.445~450 (2000)
- Gascoyne RD, "Prognostic significance of anaplastic lymphoma kinase (ALK) protein expression in adults with anaplastic large cell lymphoma", Blood, 93, pp.3913~3921 (1999)
- Weisenburger DD, "Systemic anaplastic large-cell lymphoma: results from the non-Hodgkin's lymphoma classification project", Am J Hematol, 67, pp.172~178 (2001)
- Zinzani PL, "Anaplastic large-cell lymphoma: clinical and prognostic evaluation of 90 adult patients", J Clin Oncol, 14, pp.955~962 (1996)
