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Leukaemic relapse of anaplastic large cell lymphoma, ALK negative
  1. Nabin Raj Karki1,
  2. Kristine Badin2,
  3. Natasha Savage3 and
  4. Locke Bryan1
  1. 1Hematology Oncology, Augusta University, Augusta, Georgia, USA
  2. 2Jersey City Medical Center, Jersey City, New Jersey, USA
  3. 3Pathology, Augusta University, Augusta, Georgia, USA
  1. Correspondence to Dr Nabin Raj Karki; nbnrj{at}


Anaplastic large cell lymphoma (ALCL), ALK negative (ALK−) is an aggressive lymphoproliferative disorder of mature T lymphocytes characterised by hallmark cells, CD30 positivity and lacking ALK protein expression. ALCL, ALK− has to be differentiated from peripheral T-cell lymphoma-not otherwise specified and classical Hodgkin’s lymphoma. ALK− anaplastic large cell leukaemia should be considered in a patient with a history of ALCL, ALK− presenting with new leukaemia. We report a rare presentation of relapsed ALCL, ALK− with leukaemia after autologous stem cell transplantation in a 57-year-old male. Leukaemia, either as primary presentation or secondary transformation confers worse prognosis in ALCL, ALK− with very few cases reported so far. Emergency resuscitation with leukapheresis and treatment of tumour lysis syndrome along with supportive care should be followed by combination chemotherapy. Brentuximab vedotin and stem cell transplantation are the backbone of treatment for relapsed/refractory disease.

  • haematology (incl blood transfusion)
  • oncology
  • screening (oncology)

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  • Contributors NRK drafted the case report and searched literature. NRK, KB and LB were involved in care of the patient. NRK obtained informed consent for publication. NS interpreted the peripheral smear and bone marrow study. KB, LB and NS reviewed and revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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