Acute leukemic phase of anaplastic lymphoma kinase-anaplastic large cell lymphoma: A case report and review of the literature

Background: Anaplastic large cell lymphoma (ALCL) is a rare and heterogeneous malignant tumor, which is classified as anaplastic lymphoma kinase (ALK)positive ALCL and ALK- ALCL. Many patients are diagnosed with ALCL at the stage of bone marrow involvement. However, ALCL patients with clinical manifestations consistent with acute leukemia are relatively rare.

Case summary: In this report, the patient did not receive appropriate diagnosis and treatment despite a two-year history of lymph node enlargement. Hereafter, she was admitted for B symptoms and was diagnosed as ALK-ALCL by lymph node biopsy. Then, the disease progressed to leukemia without any treatment after 2 mo. The proportion of lymphoma cells in bone marrow was as high as 96%, and the proportion of peripheral blood was 84%. She also had clinical manifestations similar to acute leukemia. After completion of chemotherapy, she developed granulocytopenia and fever and died from septicemia.

Conclusion: ALCL with leukemic presentation is a late manifestation of lymphoma with low chemotherapy tolerance and poor prognosis.