Anaplastic Large Cell Lymphoma (ALCL)

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This blog is for informational purposes only and should not be taken as medical advice. Content is sourced from third parties, and we do not guarantee accuracy or accept any liability for its use. Always consult a qualified healthcare professional for medical guidance.

What is Anaplastic Large Cell Lymphoma (ALCL)?

Anaplastic Large Cell Lymphoma (ALCL) is a rare non-Hodgkin T-cell lymphoma characterized by large, CD30-positive lymphoid cells. Subtypes include ALK-positive (better prognosis, common in younger patients), ALK-negative, and breast implant-associated ALCL (BIA-ALCL). In 2025, ALCL comprises 2-8% of lymphomas, with improved outcomes due to targeted therapies.

Symptoms

Symptoms include painless swollen lymph nodes (neck, armpit, groin), fever, night sweats, weight loss (B-symptoms), fatigue, and itching. Systemic ALCL may cause organ dysfunction; cutaneous ALCL presents as skin nodules or ulcers. BIA-ALCL causes breast swelling or lumps in implant patients. Symptoms may persist for weeks, prompting biopsy.

Causes

Causes include genetic mutations (ALK gene translocations in 50% of systemic cases), Epstein-Barr virus (EBV) in some cases, and immunosuppression. BIA-ALCL is linked to textured breast implants, with chronic inflammation as a trigger. In 2025, studies reveal how immune dysregulation and JAK/STAT pathway activation drive ALCL.

Diagnosis

Diagnosis requires lymph node or tissue biopsy with immunohistochemistry (CD30+, ALK+/-), FISH for ALK rearrangements, and imaging (CT, PET) for staging (Ann Arbor system). Bone marrow biopsy assesses systemic spread. In 2025, next-generation sequencing identifies novel mutations, refining prognosis and therapy selection.

Treatment

ALK-positive ALCL is treated with CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine, prednisone), with 80% remission. ALK-negative cases have lower response (50%). Brentuximab vedotin (anti-CD30) improves outcomes in CD30+ ALCL, with 60% response in relapsed cases. Stem cell transplant is used for refractory disease, and BIA-ALCL often resolves with implant removal and capsulectomy. In 2025, ALK inhibitors (crizotinib) enhance ALK+ outcomes.

Future Outlook

In 2025, 5-year survival is 80% for ALK-positive and 48% for ALK-negative ALCL. Brentuximab and immunotherapy have raised overall survival to 60%. Research into CAR-T cells, bispecific antibodies, and JAK inhibitors aims for 70% survival by 2030, with focus on overcoming resistance in ALK-negative cases.

Sources

The information for ALCL is sourced from Blood Journal’s “ALCL: Diagnosis and Management” for diagnosis and treatment strategies; NCI’s “Non-Hodgkin Lymphoma Treatment (PDQ®)” for ALCL-specific details; PMC’s “Molecular Pathology of ALCL” for causes and genetic insights; UCSF Health’s “Anaplastic Large Cell Lymphoma” for symptoms and prognosis; and JAMA Oncology’s “Targeted Therapies in ALCL” for 2025 advancements.