Diagnosis and treatment of anaplastic large cell non Hodgkin lymphoma in children

Velikostanični anaplastični limfomi (engl. anaplastic large cell lymphoma – ALCL) rijedak su oblik ne-Hodgkinovih limfoma. Najčešće se očituju povećanim limfinim čvorovima (LČ) - nodularni tip - ili prisutnošću bolesti u nekom drugom organu koji ima limfno tkivo - ekstranodularni tip. Kod djece koristimo St. Jude klasifikaciju, koja bolest dijeli u 4 stadija. Za dijagnostiku je potrebna biopsija tkiva, dok se stadiji određuju slikovnim metodama kao što su CT, MR I PET CT. Ove metode koristimo i za praćenje uspješnosti liječenja. Za ALCL je specifična translokacija t (2,5) (p23;35), kojom se međusobno spajaju dva gena te stvaraju fuzijski gen, koji dovodi do pojačane ekspresije ALK (eng. anaplastic lymphoma kinase). Kemoterapija je prva linija liječenja, dok se u slučaju progresije bolesti koristi transplantacija matičnih hematopoetskih stanica. U novije vrijeme za liječenje se uz kemoterapiju koristi i monoklonalno protutijelo brentuximab vedotin.Anaplastic large cell lymphoma (ALCL) is a rare form of Ne-Hodgkin's lymphoma. The most common manifestations are increased lymph nodes. It can first be reported in the lymph node - nodular type - or in some other organ with lymphatic tissue - extracellular type. Children use the St. Jude classification, which is divided into four stages. For diagnostics, biopsy is used first, while the image methods such as CT, MR and PET CT are needed for the determination of the stage of disease. These methods are also used to monitor the disease as well as the bloodstream. For ALCL it is specifically the case that there is the translation of t (2,5) (p23; 35), which connects two genes together and creates a fusion gene, which results in enhanced ALK (anaplastic lymphoma kinase) expression. Chemotherapy is the first line of treatment, while in the case of regression, are used transplants of stem cells. Recently, for treatment were started to use brentuximab, monoclonal antibodies, which are used together with chemotherapy