title: Hematopoietic stem cell transplantation in relapsed ALK+ anaplastic large cell lymphoma in children and adolescents: a study on behalf of the SFCE and SFGM-TC.
abstract: Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a treatment option for relapsed anaplastic large cell lymphoma (ALCL) in children, but reports on its efficacy in this disease are still limited. We analyzed data concerning 34 patients under 18 years of age prospectively registered in the French SFGM-TC database, who had undergone an allo-SCT for the treatment of ALK+ ALCL between 1993 and 2011. At transplant, 28 patients (82.4%) were in CR, whereas 6 exhibited detectable disease. Conditioning regimens were mostly myelo-ablative (n=31). With a median follow-up of 6 years, 5-year overall and event-free survival rates were 70% (SE=8%) and 58% (SE=9%), respectively. The 5-year cumulative incidence of relapse and treatment-related mortality was 18% (SE=7%) and 24% (SE=8%), respectively. Six patients had relapsed (median time, 141 days (35-235)). A durable CR had been obtained in 4/6 patients after injection of donor lymphocytes (n=1) or vinblastine-corticosteroid therapy (n=3). Ten patients had died, eight due to transplant toxicity and two due to progressive disease. Allo-SCT is an efficient treatment for pediatric patients with high-risk relapsed ALK+ ALCL. However, the overall morbidity of allo-SCT raises questions about its place, given the efficacy of targeted agents currently under development in this disease.
authors.affiliation: Department of Pediatric Oncology and Hematology, Hôpital Mère-Enfant, Nantes, France.
authors.forename: M
authors.initials: M
authors.lastname: Strullu
authors.affiliation: Department of Pediatric Oncology and Hematology, Hôpital Mère-Enfant, Nantes, France.
authors.forename: C
authors.initials: C
authors.lastname: Thomas
authors.affiliation: 1] Biostatistics and Epidemiology Unit, Gustave Roussy, Villejuif, France [2] Paris Sud University, Le Kremlin-Bicêtre, France.
authors.forename: M-C
authors.initials: MC
authors.lastname: Le Deley
authors.affiliation: Biostatistics and Epidemiology Unit, Gustave Roussy, Villejuif, France.
authors.forename: A
authors.initials: A
authors.lastname: Chevance
authors.affiliation: Department of Pediatric Oncology and Hematology, Hôpital Estaing, Clermont-Ferrand, France.
authors.forename: J
authors.initials: J
authors.lastname: Kanold
authors.affiliation: Department of Pediatric Hematology, IHOP, Lyon, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Bertrand
authors.affiliation: Department of Pediatric Oncology and Hematology, Hôpital Pellegrin, Bordeaux, France.
authors.forename: C
authors.initials: C
authors.lastname: Jubert
authors.affiliation: Department of Pediatric Hematology, Hôpital Robert Debré, Paris, France.
authors.forename: J-H
authors.initials: JH
authors.lastname: Dalle
authors.affiliation: Department of Pediatric Oncology and Hematology, Hôpital Hautepierre, Strasbourg, France.
authors.forename: C
authors.initials: C
authors.lastname: Paillard
authors.affiliation: Department of Pediatric Hematology, Hôpital Robert Debré, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Baruchel
authors.affiliation: Department of Pathology, Hôpital Purpan, Toulouse, France.
authors.forename: L
authors.initials: L
authors.lastname: Lamant
authors.affiliation: Department of Pediatric Hematology, Hôpital La Timone, Marseille, France.
authors.forename: G
authors.initials: G
authors.lastname: Michel
authors.affiliation: Department of Children and Adolescent Oncology, Gustave Roussy, Villejuif, France.
authors.forename: L
authors.initials: L
authors.lastname: Brugières
mesh_terms: D000293:Adolescent; D064591:Allografts; D000077548:Anaplastic Lymphoma Kinase; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D017728:Lymphoma, Large-Cell, Anaplastic / Q000401:mortality* / Q000628:therapy*; D008297:Male; D020794:Receptor Protein-Tyrosine Kinases; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D019172:Transplantation Conditioning
chemical_list: C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases
references.citation: Blood. 2000 Aug 15;96(4):1605-7
references.pmid: 10942417
references.citation: Blood. 2009 Aug 13;114(7):1429-36
references.pmid: 19528536
references.citation: Cancer J. 2012 Sep-Oct;18(5):450-6
references.pmid: 23006951
references.citation: Pediatr Blood Cancer. 2005 Jan;44(1):70-6
references.pmid: 15368550
references.citation: Ann Oncol. 2000 Jan;11(1):53-8
references.pmid: 10690387
references.citation: Br J Haematol. 2006 Apr;133(2):176-82
references.pmid: 16611309
references.citation: Pediatr Blood Cancer. 2013 Sep;60(9):1520-7
references.pmid: 23733511
references.citation: J Pediatr Hematol Oncol. 2014 Mar;36(2):e85-7
references.pmid: 23588340
references.citation: J Clin Oncol. 2011 Aug 1;29(22):3065-71
references.pmid: 21709186
references.citation: Bone Marrow Transplant. 2008 Jan;41(2):173-82
references.pmid: 18037944
references.citation: J Clin Pathol. 1997 Feb;50(2):128-34
references.pmid: 9155693
references.citation: Bone Marrow Transplant. 1999 Mar;23(5):437-42
references.pmid: 10100556
references.citation: Nat Med. 2008 Jun;14(6):676-80
references.pmid: 18469826
references.citation: Biol Blood Marrow Transplant. 2010 Feb;16(2):223-30
references.pmid: 19800015
references.citation: Br J Haematol. 2003 Apr;121(1):94-6
references.pmid: 12670336
references.citation: Haematologica. 2006 Jan;91(1):48-55
references.pmid: 16434370
references.citation: Br J Haematol. 2015 Feb;168(4):557-63
references.pmid: 25312752
references.citation: Clin Cancer Res. 2007 Jan 15;13(2 Pt 1):559-65
references.pmid: 17255278
references.citation: Leukemia. 2013 Feb;27(2):416-22
references.pmid: 22907048
references.citation: Eur J Haematol. 2005 Jul;75(1):22-6
references.pmid: 15946306
references.citation: Pediatr Blood Cancer. 2013 Dec;60(12):2018-24
references.pmid: 24038967
references.citation: Blood. 2010 Apr 22;115(16):3314-9
references.pmid: 20185586
references.citation: Blood. 2013 Jul 25;122(4):491-8
references.pmid: 23673863
references.citation: Blood. 1998 Nov 15;92(10):3591-8
references.pmid: 9808552
references.citation: Int J Cancer. 2006 Feb 1;118(3):688-95
references.pmid: 16114011
references.citation: Lancet Oncol. 2013 May;14(6):472-80
references.pmid: 23598171
references.citation: Pediatr Blood Cancer. 2008 Jan;50(1):126-9
references.pmid: 16609950
references.citation: Mod Pathol. 2001 Mar;14(3):219-28
references.pmid: 11266530
references.citation: J Clin Oncol. 2009 Oct 20;27(30):5056-61
references.pmid: 19738127
references.citation: Int J Hematol. 2010 Jul;92(1):190-3
references.pmid: 20549579
references.citation: Blood. 2014 Jan 16;123(3):334-7
references.pmid: 24297868
references.citation: Br J Haematol. 2002 Jun;117(4):812-20
references.pmid: 12060115
references.citation: Clin Cancer Res. 2012 Jul 15;18(14):3737-42
references.pmid: 22547770
references.citation: J Clin Oncol. 2012 Jun 20;30(18):2190-6
references.pmid: 22614995
references.citation: Clin Cancer Res. 2013 Jan 1;19(1):22-7
references.pmid: 23155186
references.citation: J Clin Oncol. 2010 Sep 1;28(25):3987-93
references.pmid: 20679620
references.citation: J Cancer Res Ther. 2013 Oct-Dec;9(4):649-52
references.pmid: 24518711