Treatments for childhood anaplastic large cell lymphoma

The following are treatment options for childhood anaplastic large cell lymphoma (ALCL). The healthcare team will suggest treatments based on your child’s health and specific information about the lymphoma. Treatments are often based on the stage.

Treatments for newly diagnosed childhood anaplastic large cell lymphoma

The main treatment for newly diagnosed childhood ALCL is chemotherapy.

Chemotherapy

Chemotherapy is the main treatment for childhood ALCL. Most children receive chemotherapy for 3 to 5 months, but in some treatment centres it may be given for a longer period.

Chemotherapy drugs are given in different combinations based on different treatment plans (protocols). The most common chemotherapy drugs used in combinations for ALCL are:

doxorubicin (Adriamycin)
cyclophosphamide (Procytox)
vincristine (Oncovin)
prednisone
methotrexate
mercaptopurine (Purinethol)
cytarabine (Cytosar)
dexamethasone (Decadron, Dexasone)
etoposide (Vepesid, VP-16)
ifosfamide (Ifex)
leucovorin (folinic acid)
hydrocortisone
vinblastine
daunorubicin (Cerubidine, daunomycin)
asparaginase (Kidrolase)
thioguanine (Lanvis)

Intrathecal chemotherapy may be given to prevent spread of ALCL to the brain and spinal cord (called the central nervous system, or CNS) or to treat ALCL that has spread to the CNS. This means that the drugs are given directly into the cerebrospinal fluid (CSF) around the brain and spinal cord. Intrathecal chemotherapy can include 1 to 3 of the following drugs:

methotrexate
cytarabine
hydrocortisone

Treatments for cutaneous anaplastic large cell lymphoma

Sometimes childhood ALCL develops only in the skin. This is called cutaneous ALCL. It may be treated with surgery, radiation therapy or both. Sometimes chemotherapy with low-dose methotrexate is also given.

Treatments for recurrent childhood anaplastic large cell lymphoma

Treatments for recurrent (relapsed) childhood ALCL may include more intense chemotherapy, targeted therapy or an allogeneic or autologous stem cell transplant.

Chemotherapy drugs and combinations used for recurrent ALCL include:

ifosfamide, carboplatin (Paraplatin, Paraplatin AQ) and etoposide
vinblastine
crizotinib (Xalkori)
ceritinib (Zykadia)
brentuximab vedotin (Adcetris)

Clinical trials

Children with cancer may be treated in a clinical trial. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Allen CE, Kamdar KY, Bollard CM, Gross TG. Malignant non-Hodgkin lymphomas in children. Pizzo PA & Poplack DG (eds.). Principles and Practice of Pediatric Oncology. 7th ed. Philadelphia: Wolters Kluwer; 2016: 23: 587-603.
American Cancer Society. Treating Non-Hodgkin Lymphoma in Children. 2017.
Gross TG & Perkins SL. Malignant non-Hodgkin lymphomas in children. Pizzo, P. A. & Poplack, D. G. (Eds.). Principles and Practice of Pediatric Oncology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2011: 23:pp. 663-682.
Johnston JM. Pediatric Non-Hodgkin Lymphoma Treatment and Management. 2018.
National Cancer Institute. Childhood Non-Hodgkin Lymphoma Treatment (PDQ®) Patient Version. 2018.
National Cancer Institute. Childhood Non-Hodgkin Lymphoma Treatment (PDQ®) Health Professional Version. 2018.
Truong TH, Weitzman, S, Arceci RJ. Non-Hodgkin lymphoma of childhood. Wiernik PH, Goldman JM, Dutcher JP & Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 48: pp. 1049-1072.
Woods D, McDonald, L. Non-Hodgkin lymphoma. Baggott C, Fochtman D, Foley GV & Patterson Kelly, K (eds.). Nursing Care of Children and Adolescents with Cancer. 4rd ed. APHON; 2011: 29: pp. 1023-1037.