Systemic anaplastic large cell lymphoma: Response-guided induction therapy in adults

This algorithm describes response-guided induction therapy for sALCL in adults (all disease stages and any ALK status) and post-induction management for patients with limited-stage disease (stage I and II) who have a CR on end-of-induction PET. Refer to related UpToDate material for details of diagnosis, treatment, response assessment, eligibility for autologous HCT, and post-induction management of extensive-stage sALCL in transplant-eligible patients.

ALK: anaplastic lymphoma kinase; BV+CHP: brentuximab vedotin, cyclophosphamide, doxorubicin, prednisone; CR: complete response; HCT: hematopoietic cell transplantation; PET3: positron emission tomography performed after three cycles of induction therapy; PR: partial responses; sALCL: systemic anaplastic large cell lymphoma; SD or PD: stable disease or progressive disease.

* Based on five-point (Deauville) score using Lugano criteria.

¶ The choice of observation versus autologous HCT in this setting must be individualized.

Δ PR with limited residual disease refers to a single site of persistent disease that is amenable to radiation therapy.

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Systemic anaplastic large cell lymphoma: Response-guided induction therapy in adults