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

Objective: 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. Results: 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.