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Anaplastic large cell lymphoma (ALCL) is a rare type of non-Hodgkin lymphoma.
Unlike leukaemia, in lymphoma, the cancer cells are found in organs and tissues of the lymphatic system although for few patients it can also involve the bone marrow. The lymphatic system is a network of fine vessels, glands and channels which occur throughout the body. It also conveys nutrients and cells, and is responsible for draining fluid and waste products away from tissues, and into the blood stream to be processed. The lymphatic system is an important part of the immune system and is made up of lymph nodes and vessels and of collections of lymphocytes in other tissues.
Anaplastic large cell lymphoma (ALCL) is quite rare. It is more likely to affect children and young adults, and is more commonly found in males. This type of lymphoma is usually made up of T-cells, although in some cases the type of cell making up the lymphoma is unclear. In some cases, it may only affect the skin, which is known as cutaneous ALCL.
The causes of ALCL are unknown, however it is important that you know:
The most common symptom of ALCL is a painless swelling in a lymph node, usually in the neck, armpit or groin.
Other symptoms may include:
ALCL is usually diagnosed by taking a biopsy of an enlarged lymph node or another abnormal area. It can be hard to make the diagnosis because the cells can look like other types of lymphoma under the microscope. A skin sample (biopsy) may be taken to check for cutaneous ALCL.
Other tests which may be done include:
Staging is the use of test results to show how widely the lymphoma has spread. There are four stages in the standard system used:
Stages 1-2 are known as early-stage disease and stages 3-4 are known as advanced-stage disease.
This stage description may be modified by adding the letters A, B, E or S:
The main ways in which ALCL is treated are:
Chemotherapy is the use of cell-killing drugs. These kill the cancer cells and/or stop them from dividing. Chemotherapy is normally given as a combination of drugs, which will usually include steroids. Steroids used to treat lymphoma are a laboratory-made version of chemicals naturally made by the body. They are very different from the type of steroids sometimes misused by body-builders or sportsmen.
Chemotherapy is usually given in blocks or ‘cycles’ of treatment. One cycle of treatment will consist of a series of doses of chemotherapy followed by a break for the healthy cells to recover.
Chemotherapy is the main treatment for ALCL. This type of lymphoma usually responds well to chemotherapy and treatment may make it disappear (remission). There's a risk that the lymphoma may come back in the future. If this happens, further chemotherapy and stem cell transplants can be used to try to control it.
The details of your treatment will vary depending on the stage of your ALCL and your general fitness. You will be given a chance to discuss treatment options and detailed information on your treatment plan before it starts. The side effects of treatment vary between different types of treatment and different patients. You will be given detailed information about any likely side effects before you start treatment.
We understand going through a blood cancer through journey can be difficult. It may help to talk to a close friend or relative about how you are feeling. Here are some questions that may be useful to ask your doctor.