Original ResearchLong-term outcomes of adults with first-relapsed/refractory systemic anaplastic large-cell lymphoma in the pre-brentuximab vedotin era: A LYSA/SFGM-TC study

- Long-term outcomes of adults with first-relapsed/refractory ALCL in the pre-brentuximab vedotin era are described.
- Most adults with first-relapsed/refractory ALCL have poor outcomes.
- Survival of ALK(+) and ALK(−) patients did not differ.

BackgroundLong-term outcomes of adults with first-relapsed/refractory (R/R) systemic anaplastic large-cell lymphoma (ALCL) are not definitively established and should be evaluated.Patients and methodsWe previously published the long-term outcomes of adults with ALCL initially treated with polychemotherapy in LYmphoma Study Association (LYSA) prospective clinical trials conducted during the pre-brentuximab vedotin era. Herein, we report the long-term outcomes of those patients after the first-relapsed/refractory (R/R) events.ResultsAmong the 138 (64 (anaplastic lymphoma kinase (ALK(+)) and 74 ALK(−) ALCL) adults initially treated in clinical trials, 40 (14 ALK(+) and 26 ALK(−)) first-R/R ALCL patients and their long-term outcomes were analysed. Median follow-up from the first-R/R events was 12.5 years. For ALK(+) and ALK(−) patients, respectively, median [range] findings were as follows: age at first-R/R event: 35 [19-76] and 61 [34-81] years; time between inclusion in first-line clinical trials and first-R/R events was 6 [1.5-34] and 11.1 [1-67] months (P = 0.36); with median (95% confidence interval) progression-free survival after the first-R/R events: 3.8 (0.7-14.8) and 5.3 (2.4-8.4) months (P = 0.39); and overall survival: 13.6 (0.7-89) and 8.1 (3.3-25) months (P = 0.96). ALCL was the main cause of death.ConclusionMost adults with first-R/R ALCL have poor outcomes, with no significant differences between patients with ALK(+) or ALK(−) disease. These results could be used as reference for the evaluation of new drugs to treat R/R ALCL.