Prognostic Factors in Childhood Anaplastic Large Cell Lymphoma: Long Term Results of the International ALCL99 Trial

Lara Mussolin; Marié-Cecilé Le Deley; Elisa Carraro; Christine Damm-Welk; Andishe Attarbaschi; Denise Williams; Amos Burke; Keizo Horibe; Atsuko Nakazawa; Grazyna Wrobel; Georg Mann; Monika Csóka; Anne Uyttebroeck; Rafael Fernández-Delgado Cerdá; Auke Beishuizen; Karin Mellgren; Birgit Burkhardt; Wolfram Klapper; Suzanne D. Turner; Emanuele S.G. d’Amore; Laurence Lamant; Alfred Reiter; Wilhelm Woessmann; Laurence Brugières; Marta Pillon; on behalf of the European Inter-Group for Childhood Non-Hodgkin lymphoma (EICNHL)

doi:10.3390/cancers12102747

Cancers (Sep 2020)

Prognostic Factors in Childhood Anaplastic Large Cell Lymphoma: Long Term Results of the International ALCL99 Trial

Lara Mussolin,
Marié-Cecilé Le Deley,
Elisa Carraro,
Christine Damm-Welk,
Andishe Attarbaschi,
Denise Williams,
Amos Burke,
Keizo Horibe,
Atsuko Nakazawa,
Grazyna Wrobel,
Georg Mann,
Monika Csóka,
Anne Uyttebroeck,
Rafael Fernández-Delgado Cerdá,
Auke Beishuizen,
Karin Mellgren,
Birgit Burkhardt,
Wolfram Klapper,
Suzanne D. Turner,
Emanuele S.G. d’Amore,
Laurence Lamant,
Alfred Reiter,
Wilhelm Woessmann,
Laurence Brugières,
Marta Pillon,
on behalf of the European Inter-Group for Childhood Non-Hodgkin lymphoma (EICNHL)

Affiliations

Lara Mussolin: Maternal and Child Health Department, Padua University, 35128 Padua, Italy
Marié-Cecilé Le Deley: Centre Oscar Lambret, Department of Biostatistics, CEDEX 59020 Lille, France
Elisa Carraro: Maternal and Child Health Department, Padua University, 35128 Padua, Italy
Christine Damm-Welk: University Medical Center Hospital Hamburg-Eppendorf, Pediatric Hematology and Oncology, 20246 Hamburg, Germany
Andishe Attarbaschi: Department of Pediatric Hematology and Oncology, St. Anna Children’s Hospital, Medical University of Vienna, 1090 Vienna, Austria
Denise Williams: Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
Amos Burke: Department of Paediatric Haematology, Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
Keizo Horibe: Clinical Research Centre, National Hospital Organization Nagoya Medical Center, Nagoya 460-0001, Japan
Atsuko Nakazawa: Department of Clinical Research, Saitama Children’s Medical Center, Saitama 330-8777, Japan
Grazyna Wrobel: Department of Bone Marrow Transplantation, Children Oncology and Hematology, Wroclaw Medical University, 50-367 Wroclaw, Poland
Georg Mann: Department of Pediatric Hematology and Oncology, St. Anna Children’s Hospital, Medical University of Vienna, 1090 Vienna, Austria
Monika Csóka: 2nd Department of Pediatrics, Semmelweis University, 1094 Budapest, Hungary
Anne Uyttebroeck: Department of Pediatric Hematology and Oncology, University Hospitals Leuven, 3000 Leuven, Belgium
Rafael Fernández-Delgado Cerdá: Department of Pediatrics, Obstetrics and Gynaecology, University of Valencia, 46010 Valencia, Spain
Auke Beishuizen: Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
Karin Mellgren: Department of Pediatric Haematology and Oncology, Sahlgrenska University Hospital, 41685 Gothenburg, Sweden
Birgit Burkhardt: Department of Pediatric Hematology and Oncology, University Hospital Muenster, D-48149 Muenster, Germany
Wolfram Klapper: Institute of Pathology, Hematopathology, University Hospital Schleswig Holstein, D-24105 Kiel, Germany
Suzanne D. Turner: Department of Pathology, University of Cambridge, Cambridge CB2 1QP, UK
Emanuele S.G. d’Amore: Department of Pathological Anatomy, San Bortolo Hospital, 36100 Vicenza, Italy
Laurence Lamant: Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, France—Université Toulouse III-Paul Sabatier, UMR1037 CRCT, F-31000 Toulouse, France
Alfred Reiter: Department of Pediatric Hematology and Oncology, Justus Liebig-University Giessen, 35390 Giessen, Germany
Wilhelm Woessmann: University Medical Center Hospital Hamburg-Eppendorf, Pediatric Hematology and Oncology, 20246 Hamburg, Germany
Laurence Brugières: Department of Pediatrics and Adolescents Oncology, Gustave Roussy, 94800 Villejuif, France
Marta Pillon: Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, 35128 Padua, Italy
on behalf of the European Inter-Group for Childhood Non-Hodgkin lymphoma (EICNHL)

DOI: https://doi.org/10.3390/cancers12102747
Journal volume & issue: Vol. 12, no. 10
p. 2747

Abstract

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With the aim of describing the long-term follow-up and to define the prognostic role of the clinical/pathological/molecular characteristics at diagnosis for childhood, adolescent and young adults affected by anaplastic large cell lymphoma (ALCL), we analyzed 420 patients aged up to 22 years homogeneously treated within the international ALCL99 trial. The 10-year progression free survival (PFS) was 70% and overall survival was 90%, rare late relapses occurred but no secondary malignancies were reported. Among clinical/pathological characteristics, only patients presenting a small cell/lymphohistiocytic (SC/LH) pattern were independently associated with risk of failure (hazard ratio = 2.49). Analysis of minimal disseminated disease (MDD), available for 162 patients, showed that both SC/LH pattern (hazard ratio = 2.4) and MDD positivity (hazard ratio = 2.15) were significantly associated with risk of failure in multivariate analysis. Considering MDD and SC/LH results, patients were separated into three biological/pathological (bp) risk groups: a high-risk group (bpHR) including MDD-positive patients with SC/LH pattern; a low-risk group (bpLR) including MDD-negative patients without SC/LH pattern; and an intermediate-risk group (bpIR) including remaining patients. The 10-year PFS was 40%, 75% and 86% for bpHR, bpIR and bpLR, respectively (p < 0.0001). These results should be considered in the design of future ALCL trials to tailor individual treatments.

Published in Cancers

ISSN: 2072-6694 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.mdpi.com/journal/cancers/

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