Case Report: Alectinib and CNS-directed therapy for primary or relapsed ALK-positive anaplastic large cell lymphoma with central nervous system involvement - Report - MDSpire
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Case Report: Alectinib and CNS-directed therapy for primary or relapsed ALK-positive anaplastic large cell lymphoma with central nervous system involvement
Clinical Report: Alectinib and CNS-targeted Treatment for ALK-positive ALCL
Overview
This report presents two cases of ALK-positive anaplastic large cell lymphoma (ALCL) with central nervous system (CNS) involvement, treated successfully with alectinib combined with CNS-directed chemotherapy. Both patients achieved complete remission, highlighting the potential of alectinib in this challenging clinical scenario.
Background
ALK-positive anaplastic large cell lymphoma (ALCL) is a rare T-cell lymphoma that generally has a favorable prognosis, but outcomes are poor in cases with CNS involvement. Standard therapies for CNS involvement are lacking, and emerging data suggest that ALK inhibitors like alectinib may provide effective treatment options. Understanding the efficacy of alectinib in this context is crucial for improving patient outcomes.
Data Highlights
No numerical data available in the source material.
Key Findings
ALK-positive ALCL typically presents with a favorable prognosis, but CNS involvement significantly worsens outcomes.
The first patient achieved complete remission after alectinib treatment combined with CNS-directed chemotherapy, remaining in remission for over 81 months.
The second patient, with primary isolated CNS involvement, also achieved complete remission after 20 months on alectinib maintenance.
Alectinib demonstrated efficacy in both relapsed and primary CNS ALK-positive ALCL cases.
Current treatment approaches for CNS involvement in ALCL are varied and lack standardization.
Clinical Implications
The successful use of alectinib in these cases suggests that it may be a viable treatment option for patients with ALK-positive ALCL and CNS involvement. Clinicians should consider incorporating alectinib into treatment regimens for similar patients, especially when traditional therapies fail.
Conclusion
These cases provide evidence that alectinib, in combination with CNS-directed therapies, can effectively manage ALK-positive ALCL with CNS involvement, warranting further investigation into its role in standard treatment protocols.
by Milda Mikalonytė, Vilhelmas Landsbergis, Lukas Kevličius, Skirmantė Černauskienė, Linas Davainis, Andrius Žučenka, Igoris Trociukas, Regina Pileckytė, Birutė Davainienė, Inga Šlepikienė, Gintarė Ražanskienė, Ugnius Mickys, Jonas Ražanskas, Jūratė Dementavičienė, Mindaugas Stoškus, Raminta Batiuškaitė, Laimonas Griškevičius
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