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.