Anaplastic large cell lymphoma, pediatric

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Section editor
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David Noyd, MD, MPH
University of Oklahoma
Oklahoma City, OK

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

Protocol

Study Years of enrollment Evidence
Lowe et al. 2021 (COG ANHL12P1) 2013-2017 Randomized Phase 2

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

Chemotherapy, prephase

Glucocorticoid therapy, prephase

CNS prophylaxis

5-day course

Antibody-drug conjugate therapy, induction

Chemotherapy, induction

Glucocorticoid therapy, 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 dosing details in manuscript link to PMC article PubMed NCT01979536

EICNHL ALCL99 protocol

Protocol

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

Note: the intrathecal component is only described as "triple therapy" in the manuscript.

Chemotherapy, prephase

Glucocorticoid therapy, prephase

CNS prophylaxis

5-day course

Chemotherapy, induction

Glucocorticoid therapy, 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 dosing details in manuscript PubMed NCT00006455

APO

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

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

Regimen

Study Years of enrollment Evidence
Alexander et al. 2014 (COG ANHL0131) 2004-2008 Non-randomized portion of phase 3 RCT

Chemotherapy

Glucocorticoid therapy

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 dosing details in manuscript PubMed NCT00059839

Relapsed or refractory, subsequent lines of therapy

Crizotinib monotherapy

Regimen

FDA-recommended dose
Study Years of enrollment Evidence
Mossé et al. 2013 (COG ADVL0912) 2009-2012 Phase 1/2 (RT)

Note: this was an expansion cohort of a phase 1/2 study.

Biomarker eligibility criteria

  • ALK rearrangement

Targeted therapy

28-day cycles

References

  1. COG 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 dosing details in manuscript PubMed NCT00939770