Case Report: A recurrent case of ALK-ALCL after autologous transplantation was successfully treated with BV + a modified CHEP chemotherapy containing mitoxantrone hydrochloride liposome with the addition of chidamide maintenance therapy

Zhen Shang; Qi Zhang; Wanying Liu; Jiaying Wu; Yicheng Zhang; Yi Xiao

doi:10.3389/fonc.2023.1242552

Case Report: A recurrent case of ALK-ALCL after autologous transplantation was successfully treated with BV + a modified CHEP chemotherapy containing mitoxantrone hydrochloride liposome with the addition of chidamide maintenance therapy

Front Oncol. 2023 Oct 2:13:1242552. doi: 10.3389/fonc.2023.1242552. eCollection 2023.

Authors

Zhen Shang^{1

2}, Qi Zhang^{1

2}, Wanying Liu^{1

2}, Jiaying Wu^{1

2}, Yicheng Zhang^{1

2}, Yi Xiao^{1

2}

Affiliations

¹ Department of Hematology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Immunotherapy Research Center for Hematologic Diseases of Hubei Province, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Abstract

Background: ALK-negative anaplastic large cell lymphoma (ALK-ALCL) is a rare heterogeneous malignancy of T-cell origin.ALK- ALCL has a poor prognosis, with more patients experiencing relapses and refractory to treatment, and its treatment remains challenging. We report a case with bone involvement as the main clinical manifestation of recurrent, and the patient achieved significant partial remission after brentuximab vedotin(BV) combined with a modified CHEP chemotherapy containing mitoxantrone hydrochloride liposome (PLM60) with the addition of chidamide maintenance therapy and received regular follow-up, with a disease-free survival of 16 months to date. A literature review of the clinical presentation and treatment of ALCL was also conducted to identify strategies for its diagnosis and management.

Conclusions: ALK-ALCL with bone involvement as the main manifestation of recurrent is relatively rare. Here, BV combined a modified CHEP chemotherapy containing mitoxantrone hydrochloride liposome was applied for the first time in a patient with relapsed ALK-ALCL, inducing remission and extending survival. However, further prospective studies with many patients are needed to determine the biological characteristics of this rare type of ALK-ALCL and relevant treatment strategies.

Keywords: ALK-negative anaplastic large cell lymphoma; bone involvement; brentuximab vedotin; chidamide; mitoxantrone hydrochloride liposome.

Publication types

Case Reports

Grants and funding

This work was supported by the National Natural Science Foundation of China No. 81873444, No. 82070213, No.82370196 and No. 81700152.