The prognosis of ALK-positive, anaplastic large cell lymphoma is usually favorable, but patients that are resistant to primary chemotherapy or who relapse early have always been associated with an aggressive clinical course and unfavorable prognosis. For a recurrent relapsing case of ALK-positive, anaplastic large cell lymphoma heavily pretreated by nearly 50 cycles of chemotherapeutic agents (Fig 1.), we developed a treatment schema of metronomically scheduled low-dose methotrexate, which successfully controlled the relapse more than 12 months (Fig. 2). The metronomic therapy that we identified from this case was an effective and economic option that caused less damage to other organs than other treatments; thus, it should be given consideration for the treatment of similar cases, especially in the setting of where the recurrence seems to be only skin disease or when other effective regimens are unavailable. Our study represents the first report of a well-documented case of ALK+ALCL which was refractory to various lines of therapy but which was subsequently successfully treated with a combination of prednisone and etoposide followed by low-dose MTX maintenance metronomic therapy.

Figure 1
Figure 1.
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Figure 2
Figure 2.
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Disclosures

No relevant conflicts of interest to declare.

Topics:
aftercare, disease remission, ki-1+ anaplastic large cell lymphoma, antineoplastic agents, chemotherapy regimen, etoposide, methotrexate, prednisone, skin disorders

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2014 by The American Society of Hematology
2014
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