Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2020; 8(21): 5439-5445
Published online Nov 6, 2020. doi: 10.12998/wjcc.v8.i21.5439
Acute leukemic phase of anaplastic lymphoma kinase-anaplastic large cell lymphoma: A case report and review of the literature
Huai-Feng Zhang, Yan Guo
Huai-Feng Zhang, Yan Guo, Department of Hematology, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong Province, China
Author contributions: Zhang HF and Guo Y collected and interpreted the data; Guo Y wrote the manuscript and arranged the literature; Guo Y revised the manuscript; and all authors read and approved the final manuscript.
Supported by Joint Project of Natural Science Foundation of Shandong Province, No. ZR2015HL037.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Guo, MD, Doctor, Department of Hematology, The First Affiliated Hospital of Shandong First Medical University, No. 16766 Jingshi Road, Lixia District, Jinan 250014, Shandong Province, China. qianyixueye@sina.com
Received: June 28, 2020
Peer-review started: June 28, 2020
First decision: July 24, 2020
Revised: August 14, 2020
Accepted: September 29, 2020
Article in press: September 29, 2020
Published online: November 6, 2020
Processing time: 130 Days and 23.3 Hours
Abstract
BACKGROUND

Anaplastic large cell lymphoma (ALCL) is a rare and heterogeneous malignant tumor, which is classified as anaplastic lymphoma kinase (ALK)positive ALCL and ALK- ALCL. Many patients are diagnosed with ALCL at the stage of bone marrow involvement. However, ALCL patients with clinical manifestations consistent with acute leukemia are relatively rare.

CASE SUMMARY

In this report, the patient did not receive appropriate diagnosis and treatment despite a two-year history of lymph node enlargement. Hereafter, she was admitted for B symptoms and was diagnosed as ALK-ALCL by lymph node biopsy. Then, the disease progressed to leukemia without any treatment after 2 mo. The proportion of lymphoma cells in bone marrow was as high as 96%, and the proportion of peripheral blood was 84%. She also had clinical manifestations similar to acute leukemia. After completion of chemotherapy, she developed granulocytopenia and fever and died from septicemia.

CONCLUSION

ALCL with leukemic presentation is a late manifestation of lymphoma with low chemotherapy tolerance and poor prognosis.

Keywords: Anaplastic large cell lymphoma; Anaplastic lymphoma kinase; Prognosis; Leukemic phase; Case report

Core Tip: Anaplastic large cell lymphoma (ALCL) is a rare and heterogeneous malignant tumor. Many patients are diagnosed with ALCL at the stage of bone marrow involvement. However, ALCL patients with clinical manifestations consistent with acute leukemia are relatively rare. Here, we reported an anaplastic lymphoma kinase negative ALCL patient with a two-year history of lymph node enlargement who did not receive the appropriate diagnosis and treatment and rapidly progressed to acute leukemia. This suggested that ALCL with leukemic presentation is a late manifestation of lymphoma with low chemotherapy tolerance and poor prognosis.