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The majority of cases express a chimeric fusion protein resulting in hyperactivation of anaplastic lymphoma kinase (<jats:styled-content style=\"fixed-case\">ALK<\/jats:styled-content>) as the consequence of a chromosomal translocation. Rarer cases lack expression of <jats:styled-content style=\"fixed-case\">ALK<\/jats:styled-content> fusion proteins and are categorised as <jats:styled-content style=\"fixed-case\">ALCL<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> ALK<\/jats:styled-content>\u2212. An adapted regimen of an historic chemotherapy backbone is still used to this day, yielding overall survival (<jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>) of over 90% but with event\u2010free survival (<jats:styled-content style=\"fixed-case\">EFS<\/jats:styled-content>) at an unacceptable 70%, improving little over the past 30\u00a0years. It is clear that continued adaption of current therapies will probably not improve these statistics and, for progress to be made, integration of biology with the design and implementation of future clinical trials is required. Indeed, advances in our understanding of the biology of <jats:styled-content style=\"fixed-case\">ALCL<\/jats:styled-content> are outstripping our ability to clinically translate them; laboratory\u2010based research has highlighted a plethora of potential therapeutic targets but, with high survival rates combined with a scarcity of funding and patients to implement paediatric trials of novel agents, progress is slow. However, advances must be made to reduce the side\u2010effects of intensive chemotherapy regimens whilst maintaining, if not improving, <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">EFS<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/bjh.15763","type":"journal-article","created":{"date-parts":[[2019,1,25]],"date-time":"2019-01-25T14:07:07Z","timestamp":1548425227000},"page":"1043-1054","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["From bench to bedside: the past, present and future of therapy for systemic paediatric <scp>ALCL<\/scp>,<scp> ALK<\/scp>+"],"prefix":"10.1111","volume":"185","author":[{"given":"Hugo","family":"Larose","sequence":"first","affiliation":[{"name":"Department of Pathology Division of Cellular and Molecular Pathology University of Cambridge Cambridge UK"},{"name":"European Research Initiative for ALK\u2010related malignancies (www.erialcl.net) Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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