Observation of Alectinib‐ and Crizotinib‐ included chemotherapy in children with ALK‐positive anaplastic large cell lymphoma: A single institutional experience

• Published in: Cancer medicine (Malden, MA) Vol. 12; no. 6; pp. 7182 - 7188
• Main Authors: He, Yingyi, Pei, Kunlin, Zhang, Hui, Wang, Jiayi, Su, Xiaoling, Gan, Wenting, Wang, Pengfei
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.03.2023; John Wiley and Sons Inc; Wiley
• Subjects: ALK inhibitor; ALK‐positive; Anaplastic large-cell lymphoma; Anaplastic Lymphoma Kinase; Bone marrow; Brain cancer; Brief Communication; Chemotherapy; Child; childhood; Children & youth; Crizotinib - therapeutic use; FDA approval; Females; Humans; Inhibitor drugs; Lung Neoplasms - pathology; Lymphatic system; Lymphoma; Lymphoma, Large-Cell, Anaplastic - drug therapy; Lymphoma, Large-Cell, Anaplastic - pathology; Neoplasm Recurrence, Local - drug therapy; outcome; Patients; Pediatrics; Pericardium; Protein Kinase Inhibitors - adverse effects; Remission; Remission (Medicine); Risk groups; Targeted cancer therapy; ALK-positive; anaplastic large cell lymphoma; ALK inhibitor; childhood; outcome
• DOI: 10.1002/cam4.5479
• ISSN: 2045-7634

Approximately one‐third children with anaplastic large cell lymphoma (ALCL) relapse after completion of chemotherapy, particularly for those high‐risk patients. The introduction of novel therapeutic modalities is much needed for these sub‐group patients. Two groups (n = 3, n = 4) of ALCL patients were treated with crizotinib‐ and alectinib‐included ALCL‐99 therapy, respectively, achieving complete remission rates of 66.7% and 100%. Two patients of crizotinib group relapsed, while none relapsed among the alectinib‐treated patients. Adding alectinib instead of crizotinib sufficiently suppressed and maintained the deep NPM‐ALK molecular response. ALK inhibitors were well tolerated with only grade 1 adverse events in both groups. Though a relatively small case number, this study raised the possibility that alectinib‐included therapeutic regimens may benefit the early response, in‐depth molecular remission, and persistent remission to some extent. Further studies are warranted to validate our preliminary findings. Our study raised the possibility that alectinib‐included therapeutic regimens might benefit the early response, in‐depth molecular remission, and persistent remission in children with ALK‐positive Anaplastic large cell lymphoma.