ALK-negative anaplastic large cell lymphoma with extensive peripheral blood and bone marrow involvements manifested as “leukemic phase”

Lu, Ying; Zhao, Xiaohui; Wang, Endi; Chen, Wei; Huang, Qin

doi:10.1016/j.leukres.2009.07.034

« Previous Next »Leukemia Research
Volume 34, Issue 4 , Pages 475-482, April 2010

ALK-negative anaplastic large cell lymphoma with extensive peripheral blood and bone marrow involvements manifested as “leukemic phase”

Ying Lu
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, United States
- Department of Hematology, Ningbo NO 1 Hospital, Ningbo, PR China
Xiaohui Zhao
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, United States
- Department of Pathology, University of California, Irvine, CA, United States
Endi Wang
- Department of Pathology, Duke University Medical Center, Durham, NC, United States
Wei Chen
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, United States
- Sir Run Run Hospital, Zhejiang University College of Medicine, PR China
Qin Huang
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, United States
- Corresponding author at: Division of Pathology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, United States. Tel.: +1 626 359 8111x62037; fax: +1 626 301 8463.

Received 18 June 2009; received in revised form 20 July 2009; accepted 22 July 2009. published online 07 March 2011.

Abstract

CD30-positive anaplastic large cell lymphoma (ALCL) is a distinctive malignant large cell lymphoma of T-cell lineage, often presenting in lymph node or extranodal sites. ALCL cases with extensive bone marrow and peripheral blood involvement manifested as “leukemic phase” are extremely rare and the most of those cases reported are anaplastic large cell lymphoma kinase (ALK) positive ALCL in childhood population. Here we report four adult cases of ALK-negative ALCL with extensive bone marrow and peripheral blood involvement manifested as “leukemic phase”. Circulating large lymphoma cells varied from 20 to 80% in peripheral blood and bone marrow biopsy showed various nodular or interstitial infiltrates. By reviewing the clinicopathologic data of previously reported ALCL cases with extensive bone marrow and peripheral blood involvement, there appears to be of large variations in regard to the patient's age, morphologic variants, immunophenotypic or genotypic characteristics of the disease. While most cases of ALCL with peripheral blood and bone marrow involvement were ALK-positive or carrying t(2;5) translocation, rare ALK-negative cases were also present. Leukemic ALCL patients usually have unfavourable prognosis, regardless of ALK expression.

Keywords: Anaplastic large cell lymphoma, Leukemic phase, Bone marrow and blood