Clinical Scenario

This protocol covers first-line management of primary ovarian lymphoma in the specific context of anaplastic lymphoma kinase (ALK)-negative anaplastic large-cell lymphoma (ALCL). ALK-negative ALCL is a histologically distinct subtype with its own risk stratification and treatment pathway.

Treatment Approach — Partial Overview

The first-line strategy is systemic chemotherapy, with the choice of regimen and its duration tailored to disease stage and pre-therapeutic risk profile. In select presentations, abbreviated chemotherapy followed by consolidative radiation is considered; other patients receive a longer chemotherapy course. Eligibility for consolidative autologous transplantation in first remission is also addressed within the protocol. The complete regimen options, eligibility criteria, sequencing, and supporting evidence levels are available in the full structured protocol.

References

DOI: 10.1016/j.annonc.2025.07.014

First-line treatment of anaplastic lymphoma kinase (ALK)-negative anaplastic large-cell lymphoma (ALCL):
In patients with limited-stage, non-bulky disease and a favourable pre-therapeutic risk profile, abbreviated ChT [e.g. three to four cycles of BV—cyclophosphamide—doxorubicin—prednisolone (BV-CHP) or CHOEP] [III, B] followed by consolidative ISRT (e.g. 30-40 Gy) [IV, B] can be recommended.
All other ChT-eligible patients should be offered six cycles of BV-CHP [I, A].
Six cycles of CHO(E)P is an alternative for patients with advanced-stage disease [III, B].
Consolidative ASCT in first CR can be considered for transplant-eligible, chemosensitive patients with stage III-IV disease [II, B].

View source ↗

Treatment of Primary Ovarian Lymphoma in ALK-Negative Anaplastic Large-Cell Lymphoma

References