Annals of Hematology

, Volume 97, Issue 1, pp 149–159 | Cite as

ALK expression plays different roles in anaplastic large-cell lymphomas and outcome of crizotinib use in relapsed/refractory ALK+ patients in a Chinese population

  • Ling Huang
  • Fen Zhang
  • Jialong Zeng
  • Hanguo Guo
  • Sichu Liu
  • Xiaojuan Wei
  • Feili Chen
  • Xinmiao Jiang
  • Zhanli Liang
  • Yanhui LiuEmail author
  • Wenyu LiEmail author
Original Article


The prognostic value of anaplastic lymphoma kinase (ALK) expression in patients with anaplastic large-cell lymphoma (ALCL) remains controversial. Data on the clinical features of ALCL in a Chinese population are limited. We retrospectively reviewed 1293 patients with pathologically diagnosed lymphoma at Guangdong General Hospital from June 2007 through August 2016. We evaluated the incidence of ALCL, clinical characteristics, survival status, and outcome of crizotinib use in four relapsed/refractory ALK-positive patients. Among the 1293 patients, 1193 (92.3%) were non-Hodgkin’s lymphoma, and 53 (4.4%) of whom were ALCL. Of the 50 ALCL patients, with a median age of 34 years, were evaluated. Among them, 33 (66.0%) were ALK-positive and 17 (34.0%) were ALK-negative. Significantly, more patients younger than 40 years old were ALK-positive than ALK-negative (66.7 vs. 23.5%; P = 0.003). The 5-year progression-free survival (PFS) for ALK-positive and ALK-negative patients were 61 and 11%, and the 5-year overall survival (OS) were 70 and 22%, respectively. Median PFS and OS were significantly better for patients with ALK-positive than ALK-negative (60.1 vs. 9.4 months, P = 0. 017; not reached vs. 32.7 months, P = 0.021). Multivariate analyses identified ALK expression, stage, and bone marrow involvement as independent prognostic factors for PFS and OS. Four relapsed ALK-positive patients were treated with crizotinib and two died. Our results suggest that ALK expression has different prognostic significance in patients with ALCL. Mechanisms underlying early relapse after chemotherapy and resistance to crizotinib need further investigation.


Anaplastic lymphoma kinase (ALK) Anaplastic large-cell lymphoma (ALCL) Prognostic value Crizotinib 



This work was supported by Guangdong Provincial Department of Science and Technology Fund Project (to Wenyu Li, Grant No. 2013B021800204 and Grant No.2016A050502028).

Compliance with ethical standards

Informed consent

Informed consent was obtained from all patients for being included in the study.

Competing interests

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Lymphoma Division, Cancer Center of Guangdong General HospitalGuangdong Academy of Medical SciencesGuangzhouChina
  2. 2.Pathology Department, Guangdong General HospitalGuangdong Academy of Medical SciencesGuangzhouChina
  3. 3.Shantou University Medical CollegeShantouChina

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