Treatment of Langerhans cell histiocytosis with a modified risk‐adapted protocol—experience from a tertiary cancer institute in India

Narula, Gaurav; Pradhan, Nirmalaya D.; Arora, Brijesh; Banavali, Sripad

doi:10.1002/pbc.27028

Cited by 13 publications

(11 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This study has given an overview of paediatric LCH in resource limited settings in a public sector hospital in Pakistan with 25% of children presenting at ages less than 2 years with male preponderance. In contrast to Narula et al 7 , who noticed median age of the patients as 36 months in their population. However male predominance was observed in their study group like our study.…”

Section: Discussionmentioning

confidence: 57%

“…11,12 In our study, among the children less than 2 years 38% achieved complete remission, 37% abandoned and 25% expired as demonstrated to be higher risk when presented at younger age.In the present study, only 49% of the total children had risk organ involvement with only one third able to complete treatment and rest were expired or abandoned treatment. In contrast,Narula et al 7 showed few cases with RO+ and benefited with longer maintenance of 18 months in addition to oral etoposide for 21 days in each 28 days cycle. Gadner et al also described high mortality rate associated with MS-LCH with RO+.…”

Section: Discussionmentioning

confidence: 90%

See 1 more Smart Citation

Overview of Langerhans Cell Histiocytosis among Children

Ahmad¹,

Hussain²,

Yaseen³

et al. 2021

PJMHS

View full text Add to dashboard Cite

Aim: To analyze clinical manifestations, course and outcome of Langerhans Cell Histiocytosis in children in resource limited settings lacking salvage therapy. Study design: Observational retrospective study Place and duration of study: Department of Haematology/Oncology, The Children’s Hospital, Lahore Pakistan from 1st January 2011 to 31st December 2018. Methodology: Sixty-five patients with age range from<1 to 8 years included analysing their age, gender, clinical classification, course of therapy and outcome. The major treatment was composed of either prednisolone and vinblastine or cytarabine pulses. Results: There were 59% males and 41% females. Forty-seven (72%) patients presented with multi system-LCH with 49% Risk Organ involvement. Most of them 42 (65%) had bone lesions while 15patients (23%) presented with central nervous system involvement. Forty patients (61%) have completed treatment, 11(17%) left against medical advice and 12(18%)patients expired due to progressive disease and worsening infection. Only 2 patients were put on palliation with progressive brain parenchyma disease. 22 patients (34%) had reactivations of disease requiring therapy for more than one-year (p-value=0.06), while 15 (23%) patients received two cycles of initiation therapy before continuation therapy started. The treatment initiated >6 months after the onset of symptoms in 48 (74%) patients. Conclusion: Early diagnosis and timely initiation of therapy are of utmost importance to reduce mortality and morbidity. There is a dire need of social support to reduce treatment abandonment in low-middle-income countries LMIC. Keywords: Paediatric Langerhans cell histiocytosis, Resource-limited settings, Delayed diagnosis, Abandonment

show abstract

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 90%

Overview of Langerhans Cell Histiocytosis among Children

Ahmad¹,

Hussain²,

Yaseen³

et al. 2021

PJMHS

View full text Add to dashboard Cite

show abstract

“…The children who did not respond promptly to vinblastine and prednisolone had an unfavorable prognosis with survival rate of only 10-34%. The children with refractory LCH can be treated with allogeneic hematopoietic stem cell transplantation with guarded prognosis [14]. Some children experience reactivation after initial improvement; therefore, close follow-up with complete physical examination and growth monitoring is necessary.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Langerhans cell histiocytosis presenting as skin lesion in a young child exposed to chronic passive smoking: A case report

Jondhale¹,

Tiwari²,

Jain³

et al. 2020

Indian J Child Health

View full text Add to dashboard Cite

Pulmonary Langerhans cell histiocytosis (PLCH) is a rare disease in childhood. We report a case of a 3-year-old boy who was exposed to chronic passive smoking in family presented with PLCH with isolated skin involvement. The boy presented with a history of recurrent respiratory tract infections requiring intensive care unit admissions for severe respiratory distress. The chest X-ray showed bilateral honeycombing of lungs, which was further confirmed by chest computed tomography showing diffused bilateral multiple cystic lesions with ground-glass haziness of lung parenchyma. Skin biopsy from suspected cutaneous lesions confirmed the diagnosis by positive S-100 and CD-1a. After initiating intensive chemotherapy, the patient showed significant improvement. Based on our experience, it can be suggested that knowledge of such condition with high clinical suspicion and simple skin biopsy can be a valuable modality in diagnosing PLCH in cases without putting the other internal organs at risk.

show abstract

“…The treatment of patients with neurodegeneration or with relapsed/refractory risk‐organ positive LCH remains challenging. Finally, having the goal of optimizing outcomes, is it possible to simplify complex treatments for LCH to make them accessible globally where financial and other resources might be limited (Narula et al , )?…”

Section: Discussionmentioning

confidence: 99%