Long-term Disease Control of Refractory Anaplastic Large Cell Lymphoma With Vinblastine

Abstract

Anaplastic large cell lymphoma (ALCL) is a unique clinical and pathologic subtype of lymphoma characterized by the proliferation of large, highly pleomorphic CD30-positive cells. Overall 70% to 80% of children with ALCL are cured with modern chemotherapy regimens, but the disease is often resistant to multiple therapies after relapse. Single agent vinblastine therapy has been effective in some cases of refractory ALCL. We report a case of ALCL originally diagnosed in an 8-year-old girl. After relapse, the disease was refractory to multiagent chemotherapy, but has showed remarkable response to, and dependence on, single agent vinblastine treatment for almost 7 years.

Clinical characteristics and treatment outcomes of children with anaplastic large cell lymphoma: a single center experience

“…In a number of studies, the event-free survival (EFS) rate ranged from 60% to 75%, and relapse occurred in up to 35% of patients [ 1 , 10 , 12 , 14 , 15 ]. For relapsed patients, various second-line treatments ranging from vinblastine alone to high-dose chemotherapy with hematopoietic stem cell transplantation (HSCT) have been investigated, but there is currently no consensus on the optimal treatment strategy [ 16 , 17 , 18 ]. Approximately 50% of patients with refractory disease will relapse again, and they have limited treatment options, such as palliative chemotherapy, radiotherapy, allogeneic SCT, or experimental approaches [ 19 , 20 ].…”

Successful treatment of relapsed anaplastic large cell lymphoma with vinblastine monotherapy and allo‐HSCT with reduced intensity conditioning regimen

“…In line with these results, Garner et al . reported that an 8‐year‐old girl with relapsed ALCL became dependent upon VLB for almost 7 years, because she developed fever and tender lymphadenopathy if her treatment was delayed . The present patient remained in CR during 19 weeks of VLB monotherapy (one treatment per week), but we were worried that he may suffer a second relapse or develop VLB dependency.…”

Anaplastic Large Cell Lymphoma in Central America: A Report From the Central American Association of Pediatric Hematology Oncology (AHOPCA)

“…Single agent vinblastine has shown effectiveness in the relapse setting for children with ALCL . Although vinblastine holds significant theoretical promise in LMIC, its effectiveness as a front line agent remains unproven, and data about toxicity in LMIC populations are lacking.…”

“…Single agent vinblastine has shown effectiveness in the relapse setting for children with ALCL . Although vinblastine holds significant theoretical promise in LMIC, its effectiveness as a front line agent remains unproven, and data about toxicity in LMIC populations are lacking. Targeted agents such as brentuximab vedotin, an antibody‐drug conjugate combining an anti‐CD30 antibody with a potent microtubule inhibitor, and crizotinib, a small molecule inhibitor of the ALK tyrosine kinase, appear to be very promising in terms of efficacy and safety; but their employment in LMICs is limited by availability and cost.…”