Anaplastic Large Cell Lymphoma (ALCL)

What is Anaplastic Large Cell Lymphoma?

Anaplastic Large Cell Lymphoma is a type of non-Hodgkin's lymphoma, which is cancer that starts in the lymphatic tissue. The main types of cells involved in anaplastic large cell lymphoma are white blood cells called T cells and null cells.There are lymph nodes in various parts of the body. Lymph nodes produce and store lymphocytes, a type of white blood cell that fights infection. The 2 main types of lymphocytes are T cells and B cells. Lymphocyte that does not contain the receptors of either mature B cells or T cells is called null cell. When these cells undergo changes and do not behave in the normal manner, lymphoma may result. Lymphomas are divided into two large groups: Hodgkin's lymphoma and non-Hodgkin's lymphoma. Anaplastic large cell lymphoma is classified under non-Hodgkin's lymphoma. In anaplastic large cell lymphoma, the cancer cells are mainly of T cell and null cell types. Some HIV-related cases involve B cells.

Statistics on Anaplastic Large Cell Lymphoma?

Anaplastic large cell lymphoma accounts for about 2% of lymphomas, but represents 12% of childhood lymphomas. Patients are often young when they go to see the doctor for the disease, and it is more common in male.

Risk Factors for Anaplastic Large Cell Lymphoma

The exact cause of anaplastic large cell lymphoma is unknown.

Anaplastic large cell lymphoma more common in male.

Genetic changes may be present. In some patients, there is an overexpression of a protein called anaplastic lymphatic kinase (ALK); in other words, an excessive amount of ALK is shown on the cells.

Progression of Anaplastic Large Cell Lymphoma

Anaplastic large cell lymphoma progresses very quickly to an advanced stage. Approximately half of the patients are diagnosed when anaplastic large cell lymphoma is at an early stage (Stage I or II), but the remainding half are diagnosed when anaplastic large cell lymphoma is at an advanced stage.The staging of anaplastic large cell lymphoma is according to:Stage I: when the disease involves only one lymph node region or lymphatic structure.Stage II: when it involves 2 or more lymph node regions on the same side of the diaphragm (either above or below the diaphragm).Stage III: when the disease involves 2 or more lymph node regions on both sides of the diaphragm.Stage IV: when there is involvement of body structures outside the lymph nodes.

How is Anaplastic Large Cell Lymphoma Diagnosed?

To investigate anaplastic large cell lymphoma the doctor will draw some blood to look at a number of things. The number, shape, size and other features of the blood cells will be examined under the microscope. The blood taken may also be used to look at the liver and kidney function.A urine test may be done.

Prognosis of Anaplastic Large Cell Lymphoma

The survival rate of anaplastic large cell lymphoma is high, with it being the best among those of all the aggresive lymphomas. The 5-year survival rate is more than 70%.Patients with tumours cells overexpressing the protein called ALK (demonstrating ALK on the tumour cell surface) have a better outlook with anaplastic large cell lymphoma.

How is Anaplastic Large Cell Lymphoma Treated?

The initial anaplastic large cell lymphoma treatment should be a combination chemotherapy regimen, the most popular one being the CHOP regimen (cyclophosphamide, doxorubicin, vincristine, and prednisone). Radiotherapy may be needed following chemotherapy.Recent research showed that combining chemotherapy with a type of transplantation called autologous stem cell transplantation (ASCT) produces good outcome - patients have a 5-year survival rate of over 85%.Most patients, especially those who show ALK on the tumour cell surface, have good response to anaplastic large cell lymphoma treatment and have a high survival rate.

Anaplastic Large Cell Lymphoma References

[1] Detailed Guide: Lymphoma, Non-Hodgkin's type. What Is Non-Hodgkin Lymphoma? [online]. 2004 [cited 2005 July 29]. Available from: URL: http://www.cancer.org/docroot/cri/content/cri_2_4_1x_what_is_non_hodgkins_lymphoma_32.asp[2] Kasper D et al. Harrison's principles of internal medicine. 16th ed. New York; McGraw-Hill; 2005.[3] Krishnan K, Urbanski C. Lymphoma, Malignant Anaplastic (Ki 1+) [online]. 2004 [cited 2005 July 29]. Available from: URL: http://www.emedicine.com/med/topic3205.htm