Optimal Therapy for Adults with Langerhans Cell Histiocytosis Bone Lesions
| Autor: | Carl E. Allen, M. John Hicks, Maria Angelica Cantu, Kenneth L. McClain, Mrinalini Bilgi, Philip J. Lupo |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
Pathology Anatomy and Physiology medicine.medical_treatment Cancer Treatment Adult Langerhans Cell Histiocytosis Hematologic Cancers and Related Disorders Langerhans cell histiocytosis Prednisone Basic Cancer Research Young adult Musculoskeletal System White Cells Multidisciplinary Hematology Middle Aged Vinblastine Histiocytosis Treatment Outcome Oncology Medicine Female Bone Diseases medicine.drug Research Article Adult medicine.medical_specialty Adolescent Science Young Adult medicine Humans Bone Biology Aged Retrospective Studies Chemotherapy Myeloproliferative Disorders business.industry Cancers and Neoplasms Retrospective cohort study Chemotherapy and Drug Treatment medicine.disease Histiocytosis Langerhans-Cell Myelodysplastic Syndromes business |
| Zdroj: | PLoS ONE PLoS ONE, Vol 7, Iss 8, p e43257 (2012) |
| ISSN: | 1932-6203 |
| Popis: | BackgroundThere is little data on treatment of Langerhans cell histiocytosis (LCH) in adults. Available data is on small numbers of patients with short follow-up times and no comparison of results from different treatment regimens. We analyzed the responses of adult LCH patients with bone lesions to three primary chemotherapy treatments to define the optimal one.Methods and findingsFifty-eight adult patients with bone lesions, either as a solitary site or as a component of multisystem disease, were analyzed for disease location and response to surgery, curettage, steroids, radiation, vinblastine/prednisone, 2-Chlorodeoxyadenosine (2-CdA), or cytosine arabinoside (ARA-C). The mean age of patients was 32 years, with equal gender distribution. Twenty-nine patients had 1 lesion; 16, 2 lesions; 5, 3 lesions; and 8 had 4 or more. Most bone lesions were in the skull, spine, or jaw. Chemotherapy, surgery, curettage, or radiation, but not steroids alone, achieved improvement or resolution of lesions in a majority of patients. Comparison of the three chemotherapy regimens revealed 84% of patients treated with vinblastine/prednisone either did not respond or relapsed within a year, whereas 59% of patients treated with 2-CdA and 21% treated with ARA-C failed. Toxicity was worse with the vinblastine/prednisone group as 75% had grade 3-4 neuropathy. Grade 3-4 cytopenias occurred in 37% of the 2-CdA -treated patients and 20% of the ARA-C-treated patients. The major limitation of this study is it is retrospective and not a clinical trial.ConclusionsARA-C is an effective and minimally toxic treatment for LCH bone lesions in adults. In contrast, vinblastine/prednisone results in poor overall responses and excessive toxicity. |
| Databáze: | OpenAIRE |
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