Successful bridging therapy with alectinib prior to allogeneic stem cell transplantation for refractory ALK-positive anaplastic large cell lymphoma

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  • KONO Asuka
    Department of Hematology, Yokosuka Kyosai Hospital
  • TANAKA Keisuke
    Department of Hematology, Yokosuka Kyosai Hospital Department of Hematology, Tokyo Medical and Dental University (TMDU)
  • SHIMADA Tomohito
    Department of Hematology, Yokosuka Kyosai Hospital
  • BANDO Kana
    Department of Hematology, Yokosuka Kyosai Hospital
  • TAKAHATA Atsushi
    Department of Hematology, Yokosuka Kyosai Hospital
  • KOI Satoshi
    Department of Hematology, Tokyo Medical and Dental University (TMDU)
  • YAMAMOTO Masahide
    Department of Hematology, Tokyo Medical and Dental University (TMDU)
  • MORI Takehiko
    Department of Hematology, Tokyo Medical and Dental University (TMDU)
  • TOYOTA Shigeo
    Department of Hematology, Yokosuka Kyosai Hospital

Bibliographic Information

Other Title
  • Alectinibによる完全奏効達成後に同種造血幹細胞移植を施行した難治性ALK陽性未分化大細胞リンパ腫
  • Alectinib ニ ヨル カンゼン ソウコウ タッセイ ゴ ニ ドウシュ ゾウケツ カンサイボウ イショク オ シコウ シタ ナンチセイ ALK ヨウセイ ミブンカ ダイ サイボウ リンパシュ

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Description

<p>Although alectinib is effective for relapsed or refractory ALK-positive anaplastic large cell lymphoma (ALCL) and has a favorable safety profile, its role as a bridging therapy for allogeneic hematopoietic stem cell transplantation (allo-HSCT) and the role of allo-HSCT itself in this setting are unknown. A 35-year-old man with ALK-positive ALCL experienced relapse after first-line therapy with CHOP. Brentuximab vedotin led to partial response and high-dose chemotherapy combined with autologous HSCT was performed. However, disease progressed 15 months after transplantation, and alectinib was initiated. Complete response (CR) was achieved after three months of treatment, and alectinib was continued for 5 months. After cessation of alectinib, allogeneic bone marrow transplantation from an HLA 1-locus mismatched unrelated donor was performed after conditioning with fludarabine, busulfan, and total body irradiation. GVHD prophylaxis consisted of tacrolimus and short-term methotrexate. The post-transplant course was unremarkable except for grade I acute GVHD. The lymphoma has not recurred for 2 years after allo-HSCT without resuming alectinib. The clinical course of our case suggests that alectinib bridging therapy and allo-HSCT are effective in relapsed/refractory ALK-positive ALCL.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 65 (3), 158-163, 2024

    The Japanese Society of Hematology

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