Diagnostic and therapeutic challenges of ALK-positive anaplastic large cell lymphoma: case report and literature review

ALK-positive anaplastic large cell lymphoma (ALCL ALK+) is an extremely rare aggressive T-cell lymphoma that exhibits a chromosomal translocation involving the ALK gene. It accounts for 0.5% of adult lymphomas. We present a case of a 36-year-old female patient admitted to the hospital in poor overall condition with hyperleukocytosis, lymphadenopathy, organomegaly, tachycardia, dyspnea, and overall weakness, diagnosed with ALK-positive ALCL. In the first line of treatment, a standard CHO(E)P (cyclophosphamide, doxorubicin, vincristine, (etoposide), prednisone) chemotherapy was given. In second-line therapy, combining brentuximab vedotin (BV) with conventional chemotherapy resulted in the achievement of complete remission (CR). This paper aims to highlight the challenges in making a definitive diagnosis of ALCL, to emphasize the importance of cytogenetic techniques, and to discuss current treatment options from the literature review.