The therapy of primary adult systemic CD30-positive anaplastic large cell lymphoma: Results of 40 cases treated in a single center

The outcome of a series of adult patients, affected by primary systemic CD3 0-positive anaplastic large cell lymphoma (ALCL), treated with a sequential intensive therapeutic program, has been analyzed and all data available in the literature have been reviewed. Forty consecutive, unselected patients with ALCL were treated with the F-MACHOP regimen, followed by radiotherapy (RT) for residual mediastinal disease (15 cases) and by autologous stem cel l transplantation (ASCT) conditioned with BAVC (29 cases). Eighty-nine perc ent (32/36) of the patients younger than 60 years were eligible for complet ing the sequential treatment. Since then, 3 patients in CR refused ASCT, 1 was excluded for cardiac toxicity and 3 progressed and died of disease. Thu s, 29 have been so far submitted to the transplant procedure. CR and PR rat es were 40% and 45% respectively after CHT; 52.5% and 35% after RT; 80% and 5% after ASCT with 78% of patients transplanted in PR convertin to a CR. A ctuarial overall survival is 85% at 48.5 months (93% at 66 months for the 2 9 transplanted patients) and disease free survival is 100% at 54 and 64 mon ths respectively, with no relapses observed among patients who reached a CR . Considering our data and those of the literature, it can be concluded that although the role of ASCT in the therapy of ALCL must not be considered as definitive, its efficacy in converting PR into CR and in preventing relapse s, suggests that a randomized trial comparing CHT alone vs CHT+ASCT should be undertaken.