Comprehensive study of anaplastic large cell lymphoma: clinicopathological features from Indonesia

Anaplastic large cell lymphoma (ALCL) is a rare and aggressive CD30-positive non-Hodgkin lymphoma with histopathological features overlapping Hodgkin and T-cell lymphomas. ALK-positive ALCL shows a better prognosis than ALK-negative cases, which are often associated with advanced disease. This study evaluates the epidemiological profile of ALCL in Indonesian population and its distinct histopathological characteristics and immunohistochemical expression patterns.

Among 93 ALCL cases (2013-2023) enrolled at Dr. Cipto Mangunkusumo Hospital, 13.9% were primary cutaneous ALCL, while 86.1% were systemic ALCL (consisted of 53.7% ALK-positive and 46.3% ALK-negative). ALK-positive patients were older (p = 0.009), with earlier-stage disease (p = 0.032) and nodal predilection (p = 0.032). ALK-negative cases demonstrated a shorter median survival of 23 months compared to ALK-positive cases of 28 months. Poor outcomes were associated with B symptoms and high Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scores. Given that this study was conducted at a single, government-operated tertiary care teaching hospital in Indonesia's capital, validation through multicenter prospective studies is warranted to further refine diagnostic and therapeutic strategies.