ALCL is a rare white blood cell cancer. Anyone can develop it, but people with breast implants may have a greater chance of developing a particular subtype. With treatment, the outlook is usually positive for all subtypes.
Anaplastic large cell lymphoma (ALCL) is a rare cancer that starts in white blood cells called T lymphocytes (T cells). T cells are part of your body’s immune system.
ALCL is a type of non-Hodgkin lymphoma (NHL) and also a subtype of T-cell lymphoma. According to the Lymphoma Research Foundation, ALCL represents just 1% of all cases of NHL.
A key feature of ALCL that is different than other types of NHL is the presence of a protein on the surface of the cells called CD30 antigen.
ALCL can occur:
- on your skin (cutaneous)
- throughout your body (systemic)
- near breast implants (breast implant-associated)
Your treatment and outlook will depend on the type of ALCL and where it has spread in your body.
Symptoms of ALCL can include:
- fever
- backache
- swollen lymph nodes
- weight loss
- skin rash or raised skin lesions that may itch
- fatigue (extreme tiredness or lack of energy)
- night sweats
- pain, swelling, or a lump near a breast implant (if you have breast implants)
ALCL occurs when your T cells grow out of control. Doctors currently aren’t sure why this happens, but think the following conditions
- human immunodeficiency virus (HIV)
- mycosis fungoides, another type of skin cancer that affects T cells
- pulmonary and inflammatory pseudotumors
- a skin condition called lymphomatoid papulosis
A rare form of ALCL called breast implant-associated ALCL (BIA-ALCL) develops in scar tissue around breast implants.
There are three main types of ALCL:
- primary cutaneous ALCL: appears as raised, red skin lesions and is only on the skin
- systemic ALCL: occurs throughout the body, often in the lymph nodes and sometimes in the lungs, liver, skin, or bones
- BIA-ALCL: forms next to a breast implant and is very rare
Doctors can further classify systemic ALCL into two groups:
- ALK-positive ALCL: cancer cells produce an abnormal form of a protein called anaplastic lymphoma kinase (ALK)
- ALK-negative ALCL: cancer cells produce a regular ALK protein
Doctors don’t fully understand what causes ALCL. Certain factors may increase your chances, but experts have identified
According to the Lymphoma Research Foundation, ALK-positive ALCL happens more frequently in young adults and children, and ALK-negative ALCL occurs more often in older adults.
Research suggests Black people may have a higher risk of systemic ALCL compared to white people. Other conditions like HIV and mycosis fungoides also have links to ALCL.
Doctors diagnose ALCL with a biopsy. During a biopsy, your doctor takes a sample of the tumor tissue and views the cells under a microscope.
Other tests can help your doctor understand the molecular characteristics of the cancer and if it has spread to other parts of your body. These tests may include:
- blood tests
- CT scan
- PET scan
- MRI scan
- bone marrow biopsy
Treatment for ALCL depends on the type and how far the cancer has spread.
As a first treatment, doctors usually treat both ALK-positive and ALK-negative systemic ALCL with a combination of chemotherapy and targeted therapy called BV-CHP. BV-CHP includes the drugs:
- brentuximab vedotin (Adcetris)
- cyclophosphamide
- doxorubicin hydrochloride
- prednisone
If the cancer relapses, treatment may include:
- stem cell transplant
- other targeted treatments, such as belinostat (Beleodaq) or crizotinib (Xalkori)
- higher doses of chemotherapy
Doctors may treat cutaneous ALCL with radiation therapy or surgery to remove the skin lesions. But if the lesions are widespread, treatment will be similar to systemic ALCL.
Treatment for BIA-ALCL typically involves surgery to remove the implant and some surrounding tissue.
With systemic ALCL, your outlook depends on whether the cancer is ALK-positive or ALK-negative. ALK-positive ALCL has a better outlook than ALK-negative ALCL.
The 5-year overall survival is
For cutaneous ALCL, if there is only one lesion, radiation therapy or surgery results in remission in about 95% of cases. But about 40% of people experience a relapse at some point. Still, the long-term prognosis is excellent if the cancer is confined to the skin.
Most people with BIA-ALCL are cured after removal of their implant.
Here are answers to some frequently asked questions about ALCL.
Is anaplastic large cell lymphoma curable?
Systemic ALCL is potentially curable with treatment. About 40–65% of people with systemic ALCL relapse after initial therapy, but a second round of therapy may still cure the disease.
Cutaneous ALCL usually stays confined to the skin and seldom spreads inside the body. Treatment typically results in long-term remission or cure. The skin lesions may even
BIA-ALCL is usually curable with surgery to remove your implant and the nearby cancer cells.
Is anaplastic large cell lymphoma genetic?
People with ALCL have changes in the genes of their T-cells that cause cancer, but researchers don’t know if these changes can be inherited.
How common is anaplastic large cell lymphoma from breast implants?
ALCL from breast implants is rare. The
The exact number of cases is difficult to determine due to limitations in reporting. Reports range from an incidence of
ALCL is a rare cancer of the immune system and a type of NHL. ALCL is potentially curable with treatment, but your outlook depends on the type of ALCL you have.
Once you receive a diagnosis of ALCL, talk with your doctor about treatment options. You can also ask them about any resources and support available to help you get through treatment and recovery.