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DOI: 10.1055/s-0044-1782234
Upfront Low-Dose Cytarabine with Prednisolone for Langerhans Cell Histiocytosis with Liver Dysfunction: A Ray of Hope
Funding None declared.
Abstract
The management of Langerhans cell histiocytosis (LCH) with accompanying liver dysfunction poses significant challenges, and this prompted the development of a modified low-dose cytarabine and prednisolone regimen. In this prospective observational study on children with LCH and liver dysfunction, four patients underwent induction and maintenance chemotherapy. The induction phase included 5 days of 100 mg/m2 cytarabine and 4 weeks of 40 mg/m2 daily prednisolone, with subsequent tapering. Maintenance included a regimen of 5 days of 100 mg/m2 cytarabine, along with oral prednisolone, repeated every 3 weeks. Complete disease resolution occurred after varying chemotherapy cycles. Three patients had liver transplants, and the chemotherapy resumed for 52 weeks after the transplant. In one child, chemotherapy was continued after reaching remission. In conclusion, a modified, less toxic low-dose cytarabine-based chemotherapy effectively managed LCH with liver dysfunction, with liver transplantation as a postremission treatment option.
Author Contributions
We state that all authors have contributed to the manuscript in significant ways, have reviewed and agreed upon the manuscript content.
N.G.H. contributed to the design of the study, literature studies, clinical studies, data acquisition, data analysis, statistical analysis, manuscript preparation, and manuscript editing. M.S.S. contributed to the concept and design of the study, definition of intellectual content, literature studies, manuscript preparation, manuscript editing, and manuscript reviewing. V.K.G. contributed to the concept of the study, definition of intellectual content, manuscript editing, and manuscript reviewing. D.M. contributed to the concept of the study, definition of intellectual content, manuscript editing, and manuscript reviewing.
Patient Consent
Patient consent was obtained.
Publikationsverlauf
Artikel online veröffentlicht:
23. Mai 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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