Three Years Sustained Complete Remission Achieved in a Primary Refractory <i>ALK</i>-Positive Anaplastic T Large Cell Lymphoma Treated with Crizotinib

Mahuad, Carolina; Reparaz, Maria De Los Angeles Vicente; Zerga, Marta; Aizpurua, María Florencia; Casali, Claudia; Garate, Gonzalo

doi:10.4081/rt.2016.6266

Cited by 7 publications

(11 citation statements)

References 10 publications

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“…As previously reported, CRZ is an excellent option to induce remission in refractory/relapsed ALC+ ALCL and is associated with minimal long‐term toxicity . The role of CRZ monotherapy as curative treatment remains in question due the potential development of drug resistance, dose‐limiting drug intolerance, and limited long‐term data . Our data suggest that MRD and MUD HCT after remission induction with CRZ can achieve prolonged remission with minimal transplant‐related morbidity.…”

Section: Discussionsupporting

confidence: 75%

“…HCT has historically been a potential treatment option for relapsed/refractory ALCL with a report of ~50% 5‐year overall survival irrespective of ALK status and disease status prior to HCT . Alternatively, second remission for relapsed/refractory ALK+ ALCL is often achievable with ALK tyrosine kinase inhibition via CRZ . The durability of remission and role of allogeneic HCT after CRZ remains poorly understood.…”

Section: Introductionmentioning

confidence: 99%

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Allogeneic hematopoietic cell transplant following crizotinib monotherapy for relapsed/refractory anaplastic large cell lymphoma

John

Naik

Leung

et al. 2018

Pediatric Transplantation

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Relapsed ALK-positive ALCL often is responsive to CRZ monotherapy. The subsequent role of allogeneic HCT after achieving second remission is poorly understood. We report 6 children who underwent allogeneic HCT for relapsed ALCL after CRZ. Age at transplant ranged from 10.7 to 22.6 years. Follow-up ranged from 0.9 to 4.5 years. All patients engrafted. Three of 4 patients that received a reduced-toxicity conditioning regimen containing fludarabine, alemtuzumab, and low-dose irradiation showed progressive mixed chimerism. Five patients remain in remission. One patient developed isolated CNS relapse 3.6 years after HCT despite a lack of previous CNS involvement. No acute transplant-related complications were experienced. One patient developed chronic renal disease secondary to transplant-associated microangiopathy and one patient chronic GVHD secondary to DLI. Ultimately, allogeneic HCT appears safe and potentially curative after remission induction with CRZ. The role of conditioning therapy, ablative or reduced intensity, remains uncertain for patients' post-CRZ monotherapy, and further studies may be warranted.

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Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Allogeneic hematopoietic cell transplant following crizotinib monotherapy for relapsed/refractory anaplastic large cell lymphoma

John

Naik

Leung

et al. 2018

Pediatric Transplantation

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“…Silibinin sensitized SRY (sex determining region Y)-box 2 (Sox2), a master transcriptional factor, was shown to be important in maintaining the pluripotency of embryonic stem cells and active ALK+ALCL cells exposed to a widely used chemotherapeutic drug, doxorubicin, in ALCL [ 31 , 32 ]. Crizotinib, a small molecule competitive inhibitor of anaplastic lymphoma kinase (ALK), has also shown high cytoreductive antitumour activity in anaplastic large-cell lymphoma [ 33 , 34 ]. Interestingly, it has been observed that, in crizotinib-resistant cells in ALK-rearranged lung cancer, silibinin-induced inhibition of STAT3 worked together with crizotinib to overcome resistance and restore sensitivity [ 35 ].…”

Section: Acute Myeloid Leukemiamentioning

confidence: 99%

Silibinin: an old drug for hematological disorders

Zou

Zhang

et al. 2017

Oncotarget

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IntroductionSilibinin (silybin), a non-toxic natural polyphenolic flavonoid, is the principal and the most biologically active component of silymarin. It is efficient in the treatment of acute and chronic liver disorders caused by toxins, drug, alcohol, hepatitis, and gall bladder disorders. Further, in our previous studies, we explored the anti-cancer efficacy in common cancers, such as lung, prostatic, colon, breast, bladder, as well as, hepatocellular carcinoma. Interestingly, silibinin is still not solely limited to the treatment of these diseases. Recent research endeavors suggest that silibinin may function diversely and serve as a novel therapy for hematological disorders.Areas coveredIt discovered several interesting viewpoints in the widely studied mechanisms of silibinin in the hematological disorders.Expert commentaryIn this report, we review the up-to-date findings of more potency roles of silibinin in β-thalassemia (β-TM), acute myeloid leukemia (AML), anaplastic large cell lymphoma (ALCL) and multiple myelomas (MM) therapy and attempt to clarify the mechanisms underlying its effects. There are two viewpoints: First, The functional mechanisms of silibinin in AML cells via regulating cell differentiation to exert anti-cancer effect; Second, combination treatment strategy may be a good choice.

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“…In addition, 6/13 patients died from 21 d to 6 mo while our case died within 12 d of diagnosis. Although primary pulmonary ALCL may have a rapidly progressing course, a protracted course may be seen in heavily treated cases[ 17 ]. Padhi et al [ 18 ] have recently reviewed 39 cases of pulmonary ALCL reported over the preceding 30 decades and reported that 13/39 cases were ALK-positive.…”

Section: Discussionmentioning

confidence: 99%

Rapidly progressing primary pulmonary lymphoma masquerading as lung infectious disease: A case report and review of the literature

Jiang¹,

Zhang²,

Wu³

et al. 2021

WJCC

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BACKGROUND Primary anaplastic large cell lymphoma of the lung represents a diagnostic challenge due to diverse manifestations and non-specific radiological findings, particularly in cases that lack extra-pulmonary manifestations and lung biopsy. CASE SUMMARY A 40-year-old woman presented with a 6-d history of fever, dry coughing, and dyspnea. Her white blood cell count was 20100/mm 3 with 90% neutrophils. PaO 2 was 60 mmHg and SaO 2 was 90% when breathing ambient air. Chest computed tomography (CT) identified a solid nodule, 15 mm in diameter, with a poorly defined boundary in the upper right lung, and several smaller solid nodules throughout both lungs. Pulmonary artery CT and subsequent bedside X-ray showed diffuse patchy shadows throughout both lungs. Repeated cultures of blood samples and alveolar lavage failed to identify any pathogen. Due to the mismatch between clinical and imaging features, we conducted a bone marrow biopsy, and the results showed proliferation along all three lineages but no atypical or malignant cells. The patient received empirical antibacterial, antiviral, and antifungal treatments, as well as corticosteroids. The patient’s condition deteriorated rapidly despite treatment. The patient died 6 d after hospitalization due to respiratory failure. Post-mortem lung biopsy failed to show inflammation but identified widespread infiltration of alveolar septum by anaplastic lymphoma kinase (ALK)-positive anaplastic cells. CONCLUSION ALK-positive anaplastic large cell lymphoma could present as a primary pulmonary disease without extra-pulmonary manifestations.

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Three Years Sustained Complete Remission Achieved in a Primary Refractory ALK-Positive Anaplastic T Large Cell Lymphoma Treated with Crizotinib

Cited by 7 publications

References 10 publications

Allogeneic hematopoietic cell transplant following crizotinib monotherapy for relapsed/refractory anaplastic large cell lymphoma

Allogeneic hematopoietic cell transplant following crizotinib monotherapy for relapsed/refractory anaplastic large cell lymphoma

Silibinin: an old drug for hematological disorders

Rapidly progressing primary pulmonary lymphoma masquerading as lung infectious disease: A case report and review of the literature

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