Uncommon Presentation and Therapeutic Strategies in Pediatric Relapsed/Refractory ALK-Positive ALCL.

[BACKGROUND] Anaplastic large cell lymphoma (ALCL) is an aggressive T-cell lymphoma that, rarely, can present with secondary haemophagocytic lymphohistiocytosis (HLH).

[OBSERVATIONS] A 6-year-old boy with ALK-positive ALCL and HLH required intensive care and chemotherapy, experienced multiple relapses, and ultimately achieved remission with crizotinib, ruxolitinib, dexamethasone, and allogeneic stem cell transplant.

[CONCLUSIONS] This case illustrates the clinical challenges of treating ALK-positive ALCL with concurrent HLH and highlights the role of targeted therapies. As molecular understanding of ALCL increases, integrating novel targeted agents may improve outcomes, particularly in relapsed or high-risk disease.