title: ALK- anaplastic large-cell lymphoma is clinically and immunophenotypically different from both ALK+ ALCL and peripheral T-cell lymphoma, not otherwise specified: report from the International Peripheral T-Cell Lymphoma Project.
abstract: The International Peripheral T-Cell Lymphoma Project is a collaborative effort designed to gain better understanding of peripheral T-cell and natural killer (NK)/T-cell lymphomas (PTCLs). A total of 22 institutions in North America, Europe, and Asia submitted clinical and pathologic information on PTCLs diagnosed and treated at their respective centers. Of the 1314 eligible patients, 181 had anaplastic large-cell lymphoma (ALCL; 13.8%) on consensus review: One hundred fifty-nine had systemic ALCL (12.1%) and 22 had primary cutaneous ALCL (1.7%). Patients with anaplastic lymphoma kinase-positive (ALK(+)) ALCL had a superior outcome compared with those with ALK(-) ALCL (5-year failure-free survival [FFS], 60% vs 36%; P = .015; 5-year overall survival [OS], 70% vs 49%; P = .016). However, contrary to prior reports, the 5-year FFS (36% vs 20%; P = .012) and OS (49% vs 32%; P = .032) were superior for ALK(-) ALCL compared with PTCL, not otherwise specified (PTCL-NOS). Patients with primary cutaneous ALCL had a very favorable 5-year OS (90%), but with a propensity to relapse (5-year FFS, 55%). In summary, ALK(-) ALCL should continue to be separated from both ALK(+) ALCL and PTCL-NOS. Although the prognosis of ALK(-) ALCL appears to be better than that for PTCL-NOS, it is still unsatisfactory and better therapies are needed. Primary cutaneous ALCL is associated with an indolent course.
authors.affiliation: Department of Medical Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada. ksavage@bccancer.bc.ca
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Savage
authors.forename: Nancy Lee
authors.initials: NL
authors.lastname: Harris
authors.forename: Julie M
authors.initials: JM
authors.lastname: Vose
authors.forename: Fred
authors.initials: F
authors.lastname: Ullrich
authors.forename: Elaine S
authors.initials: ES
authors.lastname: Jaffe
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Connors
authors.forename: Lisa
authors.initials: L
authors.lastname: Rimsza
authors.forename: Stefano A
authors.initials: SA
authors.lastname: Pileri
authors.forename: Mukesh
authors.initials: M
authors.lastname: Chhanabhai
authors.forename: Randy D
authors.initials: RD
authors.lastname: Gascoyne
authors.forename: James O
authors.initials: JO
authors.lastname: Armitage
authors.forename: Dennis D
authors.initials: DD
authors.lastname: Weisenburger
mesh_terms: D000328:Adult; D000077548:Anaplastic Lymphoma Kinase; D001208:Asia; D003937:Diagnosis, Differential; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016130:Immunophenotyping; D007391:International Cooperation; D017728:Lymphoma, Large-Cell, Anaplastic / Q000276:immunology / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D016411:Lymphoma, T-Cell, Peripheral / Q000276:immunology / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009656:North America; D011379:Prognosis; D011505:Protein-Tyrosine Kinases / Q000276:immunology* / Q000378:metabolism; D020794:Receptor Protein-Tyrosine Kinases; D012008:Recurrence; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D011505:Protein-Tyrosine Kinases; D020794:Receptor Protein-Tyrosine Kinases