Treatment of Primary Lymphoma of Bone in Anaplastic Large Cell Lymphoma with CNS Involvement in Patients Under 18
This protocol defines management for a rare presentation: primary lymphoma of bone occurring as anaplastic large cell lymphoma (ALCL) with central nervous system (CNS) involvement in a pediatric patient younger than 18 years.
Clinical Scenario
Anaplastic large cell lymphoma (ALCL) with confirmed CNS involvement, presenting as primary lymphoma of bone, in a patient under 18 years of age. ALCL with CNS involvement in this setting is an extremely rare entity requiring a distinct treatment pathway from standard bone lymphoma protocols.
Treatment Approach
Management follows a chemotherapy approach aligned with the CNS-positive mature B-NHL protocol, followed by cranial radiotherapy in eligible patients based on age. The complete course structure, treatment sequence, and age-stratified radiotherapy parameters are detailed in the full protocol.
References
- Patients with CNS-involvement: chemotherapy according to CNS-positive mature B-NHL followed by cranial radiotherapy (in patients > 1 year). Patients between 1 and 2 years of age receive 12 Gy and patients ≥ 2 years old, 18 Gy.
- ALCL with CNS+ are extremely rare, treatment and follow up are conducted according to the CNS+ mature B-NHL protocol followed by radiotherapy.
- <18 years old at diagnosis.
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