1. ¹Division of Hematology and Oncology, Wake Forest University-Baptist Medical Center, Winston-Salem, NC, USA
2. ²Division of Hematology/Oncology, Upstate Medical University, Syracuse, NY, USA
3. ³Department of Pathology, Wake Forest University-Baptist Medical Center, Winston-Salem, NC, USA
4. ⁴Department of Pathology, Upstate Medical University, Syracuse, NY, USA

Correspondence: Dr KW Zamkoff, Division of Hematology and Oncology, Wake Forest University-Baptist Medical Center, Winston-Salem, NC 27157, USA. E-mail: kzamkoff@notes.cc.sunysb.edu

⁵Current address: State University of New York-Stony Brook, Health Science Center, StonyBrook, NY 11794-8174, USA

Received 13 May 2003; Accepted 20 October 2003.

Abstract

Primary systemic anaplastic lymphoma kinase (ALK)-negative anaplastic large-cell lymphoma (ALCL) has a poor prognosis. This study sought to determine if high-dose therapy and ASCT results in long-term disease-free survival (DFS) in patients with recurrent, chemotherapy-sensitive ALK-negative ALCL. All patients with non-Hodgkin's lymphoma (NHL) who underwent ASCT at Wake Forest University and Upstate Medical University from 1 January 1990 to 12 December 2002 were reviewed to determine if they had T-, B- or null-cell NHL that was CD30+/CD15-/ALK negative. In all, 16 patients were thus identified as having ALK-negative ALCL. All 16 patients underwent ASCT at the time of first relapse and form the basis of this report. Median age of the 16 patients was 51 years. There were 11 males and five females. International prognostic index scores in 12 patients at the time of relapse were: low 3, LI 6 and HI 3. Of 15 patients, 13 relapsed after ASCT; one patient was lost to follow-up. Median progression-free survival for the 15 patients was 12 weeks (3–212+ weeks). Of 15 patients, 10 have died; nine of recurrent disease. Median overall survival for the 15 evaluable patients was 72 weeks. In our experience, high-dose therapy and ASCT does not produce long-term DFS in patients with recurrent chemotherapy-sensitive ALK-negative ALCL.