Ki1 Anaplastic Large Cell Lymphoma

Diagnosis

Must carefully distinguish Hodgkin disease from the Hodgkin-like variant of anaplastic large-cell lymphoma (ALCL) and differentiate from malignant histiocytosis.

Treatment

Table 16-9 and Figure 16-2 show the treatment protocol for Ki-1+ ALCL.

• Stages I and II resected treatment use strategy 1, which consists of a cytoreduc-tive chemotherapy phase followed by three courses of alternating chemotherapy courses A, B, A.

Table 16-9. Treatment of Ki-1+ Anaplastic Large-Cell Lymphoma (BFM-NHL 90 Protocol) (to be read in conjunction with Figure 16-2)

Drug Dose Days administered

Cytoreductive phasea (course)

Prednisone (orally/IV) 30 mg/m2 1-5

Cyclophosphamide (IV) 200 mg/m2 1-5

Course A

Dexamethasone (orally) 10 mg/m2 1-5

Ifosfamide (1-hour infusion) 800 mg/m2 1-5

Methotrexate (24-hour infusion)6 500 mg/m2 1

Methotrexate (lT)a 12 mga 1

Cytarabine (IT)a 30 mga 1

Prednisolone (IT)a 10 mga 1

Cytarabine (1-hour infusion) 150 mg/m2q12h 4, 5

Etoposide (1-hour infusion) 100 mg/m2 4, 5

Course B

Dexamethasone (orally) 10 mg/m2 1-5

Cyclophosphamide (1-hour infusion) 200 mg/m2 1-5

Methotrexate (24-hour infusion) 500 mg/m2 1

Methotrexate (IT)a 12 mga 1

Table 16-9. (Continued)

Drug

Dose

Days administered

Cytarabine (IT)"

30 mg"

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