Optimal therapy for adults with Langerhans cell histiocytosis bone lesions.

<h4>Background</h4>There 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...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Maria A Cantu, Philip J Lupo, Mrinalini Bilgi, M John Hicks, Carl E Allen, Kenneth L McClain
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5fff2a5e14de401c839437d6d4b8e1b7
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:5fff2a5e14de401c839437d6d4b8e1b7
record_format	dspace
spelling	oai:doaj.org-article:5fff2a5e14de401c839437d6d4b8e1b72021-11-18T07:08:37ZOptimal therapy for adults with Langerhans cell histiocytosis bone lesions.1932-620310.1371/journal.pone.0043257https://doaj.org/article/5fff2a5e14de401c839437d6d4b8e1b72012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22916233/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>There 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.<h4>Methods and findings</h4>Fifty-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.<h4>Conclusions</h4>ARA-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.Maria A CantuPhilip J LupoMrinalini BilgiM John HicksCarl E AllenKenneth L McClainPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 8, p e43257 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Maria A Cantu Philip J Lupo Mrinalini Bilgi M John Hicks Carl E Allen Kenneth L McClain Optimal therapy for adults with Langerhans cell histiocytosis bone lesions.
description	<h4>Background</h4>There 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.<h4>Methods and findings</h4>Fifty-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.<h4>Conclusions</h4>ARA-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.
format	article
author	Maria A Cantu Philip J Lupo Mrinalini Bilgi M John Hicks Carl E Allen Kenneth L McClain
author_facet	Maria A Cantu Philip J Lupo Mrinalini Bilgi M John Hicks Carl E Allen Kenneth L McClain
author_sort	Maria A Cantu
title	Optimal therapy for adults with Langerhans cell histiocytosis bone lesions.
title_short	Optimal therapy for adults with Langerhans cell histiocytosis bone lesions.
title_full	Optimal therapy for adults with Langerhans cell histiocytosis bone lesions.
title_fullStr	Optimal therapy for adults with Langerhans cell histiocytosis bone lesions.
title_full_unstemmed	Optimal therapy for adults with Langerhans cell histiocytosis bone lesions.
title_sort	optimal therapy for adults with langerhans cell histiocytosis bone lesions.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/5fff2a5e14de401c839437d6d4b8e1b7
work_keys_str_mv	AT mariaacantu optimaltherapyforadultswithlangerhanscellhistiocytosisbonelesions AT philipjlupo optimaltherapyforadultswithlangerhanscellhistiocytosisbonelesions AT mrinalinibilgi optimaltherapyforadultswithlangerhanscellhistiocytosisbonelesions AT mjohnhicks optimaltherapyforadultswithlangerhanscellhistiocytosisbonelesions AT carleallen optimaltherapyforadultswithlangerhanscellhistiocytosisbonelesions AT kennethlmcclain optimaltherapyforadultswithlangerhanscellhistiocytosisbonelesions
_version_	1718423854324383744

Optimal therapy for adults with Langerhans cell histiocytosis bone lesions.

Ejemplares similares