AI Article Synopsis
- The ALK gene rearrangement with NPM1 creates a fusion linked to anaplastic large cell lymphoma (ALCL), which typically responds well to specific chemotherapy treatments.
- The case of a 40-year-old woman with ALCL ALK+ showed her previous treatments failed, but she achieved complete remission after brentuximab and was awaiting stem cell transplant.
- Following this, crizotinib, an unapproved drug for her condition, was used successfully, leading to optimal results without adverse effects and contributing to her eligibility for the transplant.
Article Abstract
Background: The t (2; 5) chromosomal rearrangement of the ALK gene with nucleophosmin 1 gene (NPM1), resulting in an NPM1-ALK fusion, was first demonstrated in 1994 in anaplastic large cell lymphoma, (ALCL), a T-cell lymphoma responsive to cyclophosphamide, abriblastine, vincristine and prednisone in approximately 80% of cases; refractory cases usually respond favorably to brentuximab vedotin. These treatments are regarded as a bridge to allogeneic hematopoietic stem cell transplantation (allo-SCT). Nowadays, transplant procedures and the monitoring of chemotherapy patients proceed very slowly because the SARS-CoV-2 pandemic has heavily clogged the hospitals in all countries.
Results: A 40-year-old Caucasian woman was first seen at our clinical center in June 2020. She had ALCL ALK+, a history of failure to two previous therapeutic lines and was in complete remission after 12 courses of brentuximab, still pending allo-SCT after two failed donor selections. Facing a new therapeutic failure, we requested and obtained authorization from the Italian drug regulatory agency to administer 250 mg of crizotinib twice a day, a drug incomprehensibly not registered for ALCL ALK +.
Conclusions: The response to crizotinib was optimal since no adverse event occurred, and CT-PET scans persisted negative; this drug has proved to be a valid bridge to allo-SCT.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912420 | PMC |
| http://dx.doi.org/10.3390/healthcare9020135 | DOI Listing |
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