{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T18:23:43Z","timestamp":1790533423205,"version":"4.1.0"},"reference-count":33,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"34","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> To analyze the efficacy of a risk-stratified treatment of children with relapsed anaplastic large cell lymphoma (ALCL). The ALCL-Relapse trial (ClinicalTrials.gov identifier: NCT00317408 ) stratified patients according to the time of relapse and CD3 expression to prospectively test reinduction approaches combined with consolidation by allogeneic or autologous hematopoietic stem cell transplantation (SCT) and vinblastine monotherapy. <\/jats:p><\/jats:sec><jats:sec><jats:title>PATIENTS AND METHODS<\/jats:title><jats:p> Patients with progression during frontline therapy (very high risk) or a CD3-positive relapse (high risk) were scheduled for allogeneic SCT after reinduction chemotherapy. Patients with a CD3-negative relapse within 1 year after initial diagnosis or prior exposure to vinblastine (intermediate risk) received autologous SCT after carmustine-etoposide-cytarabine-melphalan. This arm was terminated prematurely, and subsequent patients received vinblastine monotherapy instead. Patients with a CD3-negative relapse &gt; 1 year after initial diagnosis (low risk) received vinblastine monotherapy. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> One hundred sixteen patients met the inclusion criteria; 105 evaluable patients with CNS-negative disease had a 5-year event-free survival (EFS) of 53% \u00b1 5% and a 5-year overall survival (OS) of 78% \u00b1 4%. Before termination of autologous SCT, EFS rates of patients in the very-high- (n = 17), high- (n = 26), intermediate- (n = 32), and low- (n = 21) risk groups were 41% \u00b1 12%, 62% \u00b1 10%, 44% \u00b1 9%, and 81% \u00b1 9%; the respective OS rates were 59% \u00b1 12%, 73% \u00b1 9%, 78% \u00b1 7%, and 90% \u00b1 6%. Analyzing only the patients in the intermediate-risk group consolidated per protocol by autologous SCT, EFS and OS of 23 patients were 30% \u00b1 10% and 78% \u00b1 9%, respectively. All 5 patients with intermediate risk receiving vinblastine monotherapy after the amendment experienced relapse again. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> Shorter time to relapse was the strongest predictor of subsequent relapse. Allogeneic SCT offers a chance for cure in patients with high-risk ALCL relapse. For early relapsed ALCL autologous SCT was not effective. Vinblastine monotherapy achieved cure in patients with late relapse; however, it was not effective for early relapses. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.20.00157","type":"journal-article","created":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T16:02:31Z","timestamp":1596124951000},"page":"3999-4009","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":54,"title":["Stem Cell Transplantation and Vinblastine Monotherapy for Relapsed Pediatric Anaplastic Large Cell Lymphoma: Results of the International, Prospective ALCL-Relapse Trial"],"prefix":"10.1200","volume":"38","author":[{"given":"Fabian","family":"Kn\u00f6rr","sequence":"first","affiliation":[{"name":"Pediatric Hematology and Oncology, University Hospital Hamburg-Eppendorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Brugi\u00e8res","sequence":"additional","affiliation":[{"name":"Department of Children and Adolescents Oncology, Gustave Roussy University Hospital, Paris-Saclay University, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Pillon","sequence":"additional","affiliation":[{"name":"Pediatric Hematology and Oncology, University Hospital of Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Hannover Medical School, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Ruf","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andishe","family":"Attarbaschi","sequence":"additional","affiliation":[{"name":"Pediatric Hematology and Oncology, St Anna Children's Hospital, Medical University of Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Mellgren","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, The Queen Silvia Children's Hospital, G\u00f6teborg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Amos A.","family":"Burke","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Oncology and Palliative Care, Cambridge University Hospital NHS Trust, Cambridge, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Uyttebroeck","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology & Hematology, University Hospitals Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gra\u017cyna","family":"Wr\u00f3bel","sequence":"additional","affiliation":[{"name":"Department of Bone Marrow Transplantation, Children's Oncology and Hematology, Wroclaw Medical University, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Auke","family":"Beishuizen","sequence":"additional","affiliation":[{"name":"Princess Maxima Center for Pediatric Oncology, Utrecht, the 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