What is anaplastic large cell lymphoma (ALCL)?

Anaplastic large cell lymphoma (ALCL) is a rare type of fast-growing non-Hodgkin lymphoma (NHL). It develops when T-cells (also called T-lymphocytes) become abnormal. T-cells are white blood cells that fight infection.

The abnormal T-cells (lymphoma cells) usually build up in lymph nodes, but they can affect other parts of the body.

People with ALCL are divided into two groups. These are:

  • ALK-positive
    This is where the lymphoma cells have a protein called anaplastic lymphoma kinase (ALK).
  • ALK-negative
    This is where the lymphoma cells do not have the ALK protein.

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Symptoms of anaplastic large cell lymphoma (ALCL)

Painless swelling in neck, armpit or groin

This is the most common sign of ALCL. It is caused by lymphoma cells building up in the lymph nodes, which make them bigger.

B symptoms

Some people also have:

  • drenching night sweats
  • high temperatures (fevers) with no obvious cause
  • unexplained weight loss

Doctors call this group of symptoms B symptoms.

Other symptoms

ALCL may also affect other parts of the body outside the lymph nodes. This is called extranodal disease. Symptoms depend on the area affected.

General symptoms may include loss of appetite and tiredness.

We have more information about the signs and symptoms of lymphoma.

Causes of anaplastic large cell lymphoma (ALCL)

The causes of ALCL are mostly unknown. Like other cancers, it is not infectious and cannot be passed on to other people. It is more likely to affect children and young adults, and it is more common in males than females.

Very rarely, breast implants are linked to ALCL. The lymphoma often only affects the area around the breast implant and is treated with surgery.

We have more information about causes and risk factors of non-Hodgkin lymphoma.

Diagnosis of anaplastic large cell lymphoma (ALCL)

Biopsy

The most common test for this lymphoma is to remove part or all of an enlarged lymph node (a biopsy). This may be done under local or general anaesthetic. The biopsy is then sent to a laboratory to be checked for lymphoma cells. You may also have biopsies taken from other areas of the body.

You can read more about further tests you may have in our information about non-Hodgkin lymphoma.

Waiting for test results can be a difficult time. It may help to talk to your family, friends or specialist nurse.

Staging and grading of anaplastic large cell lymphoma (ALCL)

The results of your tests help your doctors find out how many areas of the body are affected by lymphoma and where these areas are. This is called staging.

Lymphomas are also grouped as either low-grade or high-grade. Low-grade lymphomas are usually slow growing and high-grade lymphomas grow more quickly. ALCL is a high-grade lymphoma.

We have more information about staging and grading of non-Hodgkin lymphoma.

Treatment for anaplastic large cell lymphoma (ALCL)

A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).

Your doctor or cancer specialist or nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions.

Your treatment may depend on:

  • the stage of the lymphoma
  • your general health
  • whether the lymphoma is ALK-positive or ALK-negative.

Treatments for ALCL may include the following:

  • Chemotherapy

    Chemotherapy is an important treatment for ALCL and can often get the lymphoma into remission. The most common drug treatment used is called CHOP. More intensive combinations of drugs may be used to treat young adults and children with ALCL. This may mean longer stays in hospital.

  • Steroids

    Steroids are drugs that are often given with chemotherapy to treat lymphomas. They help make chemotherapy more effective.

  • Radiotherapy

    Radiotherapy uses high-energy rays to destroy cancer cells, while doing as little harm as possible to normal cells. Some people have radiotherapy after chemotherapy to treat an area of lymphoma. This can treat any remaining lymphoma cells in the area. It can also reduce the risk of lymphoma coming back in that area.

  • Stem cell transplants

    Stem cell transplants are sometimes used if there are still signs of ALCL or it comes back after other treatments. Stem cell transplants are intensive treatments, so it is not suitable for everyone. You may have a tranplant:

  • Targeted therapy

    Targeted therapies are drugs that use unique features of the cancer to find and treat cancer cells. A drug called brentuximab vedotin is used if there are still signs of ALCL or it comes back after other treatments.

ALCL usually responds well to chemotherapy, and treatment may make it disappear (called remission). There is a risk that the lymphoma may come back (relapse) in the future. If this happens chemotherapy and stem cell transplants can be used to try and control it.

We have more information about treating lymphoma that has come back.

You may have some treatments as part of a clinical trial.

After anaplastic large cell lymphoma (ALCL) treatment

You have regular follow-up appointments after treatment. These appointments are a good opportunity for you to talk to your doctor or nurse about any concerns you have. Your doctor will want to know how you are feeling generally, and to check you are recovering from any side effects of treatment.

Well-being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes such as eating well and keeping active can improve your health and wellbeing and help your body recover.

Getting support

Everyone has their own way of dealing with illness and the different emotions they experience. You may find it helpful to talk things over with family and friends or your doctor or nurse.

Macmillan can offer emotional, practical and financial help and support.

The organisations below also offer information and support:

  • Blood Cancer UK
    Blood Cancer UK is a blood cancer research charity that provides information and support on any type of blood cancer.
  • Lymphoma Action 
    Lymphoma Action gives emotional support, advice and information on all aspects of Hodgkin lymphoma and non-Hodgkin lymphoma. It has a national network of people with lymphoma, and local groups.

About our information

  • References

    Below is a sample of the sources used in our anaplastic large cell lymphoma (ALCL) information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk 

    National Institute for Health and Care Excellence (NICE). Non-Hodgkin’s lymphoma: diagnosis and management. 2016. Available from: www.nice.org.uk/guidance/ng52.

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Anne Parker, Consultant Haematologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

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