Comparison of vindesine and prednisone and cyclophosphamide, etoposide, vindesine, and prednisone as first-line treatment for adult Langerhans cell histiocytosis: A single-center retrospective study. (March 2016)

• Record Type: Journal Article
• Authors: Duan, M.-H.; Han, X.; Li, J.; Zhang, W.; Zhu, T.-N.; Han, B.; Zhuang, J.-L.; Wang, S.-J.; Cao, X.-X.; Cai, H.-C.; Chen, M.; Yang, C.; Zhou, D.-B.
• Is Part Of: Leukemia research. Volume 42(2016:Mar.)
• Page Start: 43
• Page End: 46
• Publication Date: 2016-03
• Subjects: Histiocytosis -- Langerhans-cell histiocytosis -- Adult -- Multisystem -- Chemotherapy; Leukemia -- Periodicals; Leukemia -- Periodicals; Leucémie -- Périodiques; Leukemia; Periodicals; Electronic journals; Electronic journals; 616.9941905
• DOI: 10.1016/j.leukres.2016.01.012
• Languages: English
• ISSNs: 0145-2126

Abstract

Highlights: Two regimens as the first line treatment in adult LCH were compared. Two regimens for the treatment of adult SS-m or MS LCH showed similar efficacy. Treatment with two regimens was associated with a high recurrence rate. Abstract: Objective: We compared the efficacy and clinical outcomes of vindesine and prednisone (VP) and cyclophosphamide, etoposide, vindesine, and prednisone (CEVP) regimens as first-line treatment for multisystem (MS) or multifocal single system (SS-m) adult Langerhans cell histiocytosis (LCH). Method: Clinical features, treatment response, and survival of adults with Langerhans cell histiocytosis treated at our center from January 2001 to January 2015 were reviewed retrospectively. Results: Forty-five adult MS or SS-m LCH patients were treated ( N = 31, CEVP group; N = 14, VP group). Both treatment groups had similar gender distributions, patient ages, and extent of disease. The non-active disease rate for both groups was 70.0% and 64.3% ( P = 0.775), respectively. Median follow-up was 74.9 (range: 2.8–183.6) months and recurrence rates were 71.0% and 78.6% ( P = 0.593), respectively. The need for second-line therapy was 64.5% and 71.4% ( P = 0.649), respectively, and mortality rates were 9.7% and 15.4% ( P = 0.586), respectively. Neutropenia occurred in 48.4% of CEVP-treated patients and 7.1% of VP-treated patients ( P = 0.008). Conclusions: CEVP or VP regimens for the treatment of adult SS-m or MS LCH showed similar efficacies, and both regimens were associated with high disease recurrence and the need for second-line therapy.