Anaplastic large cell lymphoma, pediatric

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Wayne H. Liang, MD, MS, FAMIA
Children’s Healthcare of Atlanta/Emory
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This page contains studies that were specific to pediatric populations. For the more general ALCL page, follow this link.

3 regimens on this page
3 variants on this page


Untreated

COG ANHL12P1 protocol

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Protocol

Study Years of enrollment Evidence
Lowe et al. 2021 (COG ANHL12P1) 2013-2017 Randomized Phase II

Note: there appear to be several dosing errors in Table 2; the authors have been contacted for clarification.

Chemotherapy, prophase

CNS prophylaxis

5-day course

Antibody-drug conjugate therapy, induction

Chemotherapy, induction

21-day cycle for 6 cycles

References

  1. COG ANHL12P1: Lowe EJ, Reilly AF, Lim MS, Gross TG, Saguilig L, Barkauskas DA, Wu R, Alexander S, Bollard CM. Brentuximab vedotin in combination with chemotherapy for pediatric patients with ALK+ ALCL: results of COG trial ANHL12P1. Blood. 2021 Jul 1;137(26):3595-3603. link to original article contains verified protocol PubMed NCT01979536

EICNHL ALCL99 protocol

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Protocol

Study Years of enrollment Evidence Comparator Comparative Efficacy Comparative Toxicity
Brugières et al. 2009 (EICNHL ALCL99) 1999-2005 Randomized (E-switch-ic) Alternate MTX dosing Inconclusive whether non-inferior EFS Less toxic

Chemotherapy, prophase

CNS prophylaxis

  • Triple-therapy IT once on day 1

5-day course

Chemotherapy, induction

21-day cycle for 6 cycles

References

  1. EICNHL ALCL99: Brugières L, Le Deley MC, Rosolen A, Williams D, Horibe K, Wrobel G, Mann G, Zsiros J, Uyttebroeck A, Marky I, Lamant L, Reiter A. Impact of the methotrexate administration dose on the need for intrathecal treatment in children and adolescents with anaplastic large-cell lymphoma: results of a randomized trial of the EICNHL Group. J Clin Oncol. 2009 Feb 20;27(6):897-903. Epub 2009 Jan 12. link to original article contains verified protocol PubMed NCT00006455

HOP

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HOP: Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone
APO: Adriamycin (Doxorubicin), Prednisone, Oncovin (Vincristine)

Regimen

Study Years of enrollment Evidence
Alexander et al. 2014 (COG ANHL0131) 2004-2008 Non-randomized portion of phase III RCT

Chemotherapy

CNS prophylaxis

6-week course

Subsequent treatment

  • APO versus APV maintenance

References

  1. COG ANHL0131: Alexander S, Kraveka JM, Weitzman S, Lowe E, Smith L, Lynch JC, Chang M, Kinney MC, Perkins SL, Laver J, Gross TG, Weinstein H. Advanced stage anaplastic large cell lymphoma in children and adolescents: results of ANHL0131, a randomized phase III trial of APO versus a modified regimen with vinblastine: a report from the children's oncology group. Pediatr Blood Cancer. 2014 Dec;61(12):2236-42. Epub 2014 Aug 23. link to original article link to PMC article contains verified protocol PubMed NCT00059839

Relapsed or refractory, subsequent lines of therapy

Crizotinib monotherapy

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Regimen

FDA-recommended dose
Study Years of enrollment Evidence
Mossé et al. 2013 (ADVL0912) 2009-2012 Non-randomized (RT)

Note: this was an expansion cohort of a phase I study.

Biomarker eligibility criteria

  • ALK rearrangement

Targeted therapy

28-day cycles

References

  1. ADVL0912: Mossé YP, Lim MS, Voss SD, Wilner K, Ruffner K, Laliberte J, Rolland D, Balis FM, Maris JM, Weigel BJ, Ingle AM, Ahern C, Adamson PC, Blaney SM. Safety and activity of crizotinib for paediatric patients with refractory solid tumours or anaplastic large-cell lymphoma: a Children's Oncology Group phase 1 consortium study. Lancet Oncol. 2013 May;14(6):472-80. Epub 2013 Apr 16. link to original article link to PMC article contains verified protocol PubMed NCT00939770