Lymphomas expressing anaplastic lymphoma kinase (ALK) represent two distinct lymphoma entities: ALK-positive T-/null-cell anaplastic large cell lymphoma (ALK + ALCL) and ALK-positive large B-cell lymphoma (ALK + LBCL). In both subtypes, the inappropriate expression of ALK is driven by 2p23/ALK-involving chromosomal translocations found to target several partner genes. These translocations lead to constitutively activated and oncogenic ALK fusions, of which nucleophosmin (NPM1)-ALK associated with t(2;5)(p23;q35) is the most common. Recently, various ALK fusions, including those previously described in lymphomas, have been identified in several types of nonhaematological malignancy. Identification of further types of ALK + tumours is clinically important because in future these patients may benefit from targeted therapy, already applied in neoplasms driven by, for example, the mutated ABL1, KIT and PDGFRA/B tyrosine kinases.In this article, we will focus mainly on oncogenic ALK rearrangements in lymphomas and their molecular consequences.
KeywordsOncogene, anaplastic lymphoma kinase, anaplastic large cell lymphoma, large B-cell lymphoma The inappropriate expression of ALK in ALK + ALCL derives from chromosomal translocations targeting the 2p23/ALK locus. Occurring in 84% of ALK + ALCL, the most frequent, t(2;5)(p23;q35), results in the fusion of the amino-terminal end of NPM (currently designated as NPM1) with the intracytoplasmic portion of ALK.