Document Detail

Long-Term Outcome of Adults With Systemic Anaplastic Large-Cell Lymphoma Treated Within the Groupe d'Etude des Lymphomes de l'Adulte Trials.
MedLine Citation:
PMID:  23045585     Owner:  NLM     Status:  Publisher    
PURPOSESystemic anaplastic large-cell lymphoma (ALCL) is a T-cell lymphoma, whose anaplastic lymphoma kinase (ALK) expression varies according to age. Long-term outcomes of chemotherapy-treated adults are not definitively established and should be evaluated. PATIENTS AND METHODSPatients treated in three Groupe d'Étude des Lymphomes de l'Adulte prospective clinical trials with confirmed systemic ALCL after immunohistopathologic review and defined ALK expression status were analyzed.ResultsAmong the 138 adult patients with ALCL, 64 (46%) were ALK positive, and 74 (54%) were ALK negative. Median follow-up was 8 years. At diagnosis, significantly more patients younger than 40 years old were ALK positive than ALK negative (66% v 23%, respectively; P < .001). Comparing patients with ALK-positive and ALK-negative ALCL, β(2)-microglobulin was ≥ 3 mg/L in 12% and 33% (P = .017); International Prognostic Index was high (score, 3 to 5) in 23% and 48% (P = .03); complete response rates to first-line treatment were 86% and 68% (P = .01); and 8-year overall survival (OS) rates were 82% (95% CI, 69% to 89%) and 49% (95% CI, 37% to 61%), respectively (P < .001). The survival difference mostly affected patients age ≥ 40 years. Multivariate analysis identified β(2)-microglobulin ≥ 3 mg/L (P < .001) and age ≥ 40 years (P = .029), but not ALK status, as prognostic for OS. These two variables distinguished four survival risk groups, with 8-year OS ranging from 84% to 22%. CONCLUSIONResults of this long-term study enabled refinement of the prognosis of adult systemic ALCL, with ALK prognostic value dependent on age, and could provide guidance for eventual treatment adjustment.
David Sibon; Marion Fournier; Josette Brière; Laurence Lamant; Corinne Haioun; Bertrand Coiffier; Serge Bologna; Pierre Morel; Jean Gabarre; Olivier Hermine; Anne Sonet; Christian Gisselbrecht; Georges Delsol; Philippe Gaulard; Hervé Tilly
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-8
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  -     ISSN:  1527-7755     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
David Sibon and Olivier Hermine, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre National de la Recherche Scientifique, Unité Mixte de Recherche 8147, Université Paris Descartes, Sorbonne Paris Cité; Josette Brière, Hôpital Saint-Louis, AP-HP, Institut National de la Santé et de la Recherche Médicale (INSERM) U728, Université Paris Diderot, Sorbonne Paris Cité; Jean Gabarre, Hôpital Pitié-Salpêtrière, AP-HP; Christian Gisselbrecht, Hôpital Saint-Louis, AP-HP, Université Paris Diderot, Sorbonne Paris Cité, Paris; Marion Fournier, Groupe d'Étude des Lymphomes de l'Adulte Recherche Clinique, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon; Bertrand Coiffier, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Université Claude-Bernard Lyon 1, Pierre-Bénite; Laurence Lamant and Georges Delsol, Hôpital Purpan, INSERM U1037, Université Paul-Sabatier, Toulouse; Corinne Haioun, Hôpital Henri-Mondor, AP-HP, Université Paris-Est; Philippe Gaulard, Hôpital Henri-Mondor, AP-HP, INSERM U955, Université Paris-Est, Créteil; Serge Bologna, Hôpital Brabois, Vandoeuvre-lès-Nancy; Pierre Morel, Centre Hospitalier de Lens, Lens; Hervé Tilly, Centre Henri-Becquerel, Rouen, France; and Anne Sonet, Université Catholique de Louvain Mont-Godinne, Yvoir, Belgium.
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