The spectrum of anaplastic large-cell lymphoma

Anaplastic large-cell lymphoma (ALCL) is defined as a group of T-cell non-Hodgkin lymphomas (NHLs) which show unifying pathological characteristics, but heterogeneous clinical and genetic features. The World Health Organization includes four distinct ALCL entities: anaplastic lymphoma kinase-positive (ALK+) ALCL, ALK-negative (ALK-) ALCL, primary cutaneous (pc) ALCL, and breast implant-associated ALCL (BIA-ALCL, a newly included provisional entity). Patients diagnosed with ALCL require pretreatment evaluation. CD30 and ALK are required for accurate diagnosis and subclassification, and also serve as therapeutic targets in ALCL. Strategies to improve outcomes in ALCL include the design of next generation drugs and the use of combined therapies that simultaneously target multiple nodes essential for cell survival. Immune checkpoint inhibitors work by blocking checkpoint proteins from binding with their partner proteins and have been approved by the FDA for a variety of cancer types.