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Blood, 1 October 2007, Vol. 110, No. 7, pp. 2259-2267.
Prepublished online as a Blood First Edition Paper on May 22, 2007; DOI 10.1182/blood-2007-04-060715.
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REVIEW IN TRANSLATIONAL HEMATOLOGY
Pathobiology of ALK+ anaplastic large-cell lymphoma
Hesham M. Amin1, and
Raymond Lai2
1 Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston;
2 Department of Laboratory Medicine and Pathology, Cross Cancer Institute and The University of Alberta, Edmonton, Canada
Anaplastic large-cell lymphoma (ALCL) was initially recognized on the basis of morphologic features and the consistent expression of CD30. It then became evident that the majority of these tumors are derived from lymphoid cells of T or null immunophenotype. The subsequent finding that t(2;5)(p23;q35) occurs in 40% to 60% of ALCL patients established a distinct clinicopathologic entity. This chromosomal translocation induces the formation of the chimeric protein nucleophosmin–anaplastic lymphoma kinase (NPM-ALK), which possesses significant oncogenic potential resulting from the constitutive activation of the tyrosine kinase ALK. In addition to its specific pathophysiologic events, NPM-ALK–expressing lymphoma presents with consistent clinical manifestations. Only 13 years after the identification of NPM-ALK, tremendous progress has been made in our understanding of this molecule because of the relentless efforts of multiple investigators who have dissected its biologic roles using in vitro and in vivo experimental models. Several upstream modulators, cross-reacting oncogenes, and downstream effectors of NPM-ALK have been identified and characterized. Understanding these interacting oncogenic systems is expected to facilitate the design of new therapeutic strategies and agents. In this review, we briefly discuss ALCL and focus on NPM-ALK.
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