Antonello Sica1, Caterina Sagnelli2, Beniamino Casale3, Gino Svanera4, Massimiliano Creta5, Armando Calogero6, Renato Franco7, Evangelista Sagnelli2, Andrea Ronchi7. 1. Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy. 2. Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy. 3. Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy. 4. Department of Medical Area ASLNA2 NORTH, 80014 Giugliano, Italy. 5. Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy. 6. Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy. 7. Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
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.
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 brentuximabvedotin. 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.
Entities:
Keywords:
ALK+ patients; anaplastic large cell lymphomas ALK+; anticancer therapy; bridge therapy in NHL ALK+; crizotinib
Authors: Yael P Mossé; Stephan D Voss; Megan S Lim; Delphine Rolland; Charles G Minard; Elizabeth Fox; Peter Adamson; Keith Wilner; Susan M Blaney; Brenda J Weigel Journal: J Clin Oncol Date: 2017-08-08 Impact factor: 44.544
Authors: Antonello Sica; Beniamino Casale; Maria Teresa Di Dato; Armando Calogero; Alessandro Spada; Caterina Sagnelli; Mario Santagata; Pietro Buonavolontà; Alfonso Fiorelli; Anna Salzano; Concetta Anna Dodaro; Erika Martinelli; Elisabetta Saracco; Teresa Troiani; Dario Tammaro; Fortunato Ciardiello; Alfonso Papa Journal: Open Med (Wars) Date: 2019-10-17
Authors: Antonello Sica; Beniamino Casale; Caterina Sagnelli; Maria Teresa Di Dato; Pietro Buonavolontà; Anna Maria Salzano; Evangelista Sagnelli; Vincenzo Famiglietti; Elisabetta Saracco; Dario Tammaro; Alfonso Papa Journal: Front Neurol Date: 2020-11-13 Impact factor: 4.003