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The Indian Journal of Pediatrics

, Volume 83, Issue 3, pp 214–219 | Cite as

Langerhans Cell Histiocytosis (LCH) in Egyptian Children: Does Reactivation Affect the Outcome?

  • Mohamed Sedky Mahmoud SedkyEmail author
  • Hany Abdel Rahman
  • Emad Moussa
  • Hala Taha
  • Tarek Raafat
  • Omayma Hassanein
Original Article

Abstract

Objective

To report a single centre outcome of management of Langerhans cell histiocytosis (LCH), a clonal disease with involvement of various body systems.

Methods

Retrospective analysis of 80 pediatric LCH patients at Children Cancer Hospital-Egypt between July 2007 and December 2011 was performed. Patients were stratified and treated according to LCH III protocol. The median follow up period was 42 mo (range: 1.18 to 71 mo).

Results

At wk 6 and 12, ‘better’ response was obtained in 61 (76 %) and 74 (93 %) patients respectively. Afterwards, reactivation occurred in 25 patients (38 %), of them multiple episodes occurred in 5 patients (6.25 %), managed by repetition of 1st line treatment for once or more. The 5 y overall survival (OS) and event free survival (EFS) was 96.3 and 55 % respectively. At last follow up, better status was reached in 70 patients, 3 in each ‘intermediate’ and ‘worse’ status. Three high risk patients died and one patient was lost to follow up.

Conclusions

In a single Egyptian pediatric LCH experience, the response to treatment is satisfactory and survival remains the rule except in high risk organs disease that still needs a new molecule for salvage. However in multiple reactivations, patients do well with repetition of the 1st line of treatment with or without methotrexate.

Keywords

LCH Risk organs Response Reactivation Survival 

Notes

Acknowledgments

The authors acknowledges Dr. Jean Donadieu, Pediatric Hemato Oncologist, Service d'Hémato-Oncologie Pédiatrique, Hopital Trousseau, Paris, France, for his effort in guiding his team during the preparation of this manuscript. His vast experience in Histiocytosis was the light that they followed for reaching the end of this work.

Conflict of Interest

None.

Source of Funding

None.

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Copyright information

© Dr. K C Chaudhuri Foundation 2015

Authors and Affiliations

  • Mohamed Sedky Mahmoud Sedky
    • 1
    • 2
    Email author
  • Hany Abdel Rahman
    • 3
    • 4
  • Emad Moussa
    • 4
    • 5
  • Hala Taha
    • 6
    • 7
  • Tarek Raafat
    • 8
  • Omayma Hassanein
    • 9
  1. 1.Department of PediatricsNational Research CentreCairoEgypt
  2. 2.Department of Pediatric OncologyChildren Cancer HospitalCairoEgypt
  3. 3.Department of Pediatric Oncology, National Cancer InstituteCairo UniversityCairoEgypt
  4. 4.Children Cancer HospitalCairoEgypt
  5. 5.Department of Clinical OncologyMenoufeya UniversityCairoEgypt
  6. 6.Department of PathologyChildren Cancer HospitalCairoEgypt
  7. 7.National Cancer InstituteCairo UniversityCairoEgypt
  8. 8.Department of RadiologyNational Cancer Institute, Cairo University, Children Cancer HospitalCairoEgypt
  9. 9.Department of Clinical ResearchChildren Cancer HospitalCairoEgypt

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