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Treatment of refractory Langerhans cell histiocytosis (LCH) with a combination of 2-chlorodeoxyadenosine and cytosine arabinoside.

Abstract
The combination of 2-chlorodeoxyadenosine (2-CDA) and cytosine arabinoside (Ara-C) has been shown to be effective in children with refractory Langerhans cell histiocytosis (LCH). We have treated 5 patients with recurrent LCH with 2-CDA/Ara-C chemotherapy and closely followed immune and hematopoietic function. These patients display a decline in the absolute CD4, CD8, and natural killer cell number, decrease in the CD4/CD8 ratio. Septic events, including pneumocystis infection were present after most of the treatment courses (15/21). These data suggest that 2-CDA /Ara-C, should be considered in resistant and relapsed pediatric patients with LCH with high-risk multiorgan involvement. Consequent profound prolonged combined immune deficiency and myelosupression should be anticipated.
AuthorsNataly Apollonsky, Jeffrey M Lipton
JournalJournal of pediatric hematology/oncology (J Pediatr Hematol Oncol) Vol. 31 Issue 1 Pg. 53-6 (Jan 2009) ISSN: 1536-3678 [Electronic] United States
PMID19125089 (Publication Type: Journal Article)
Chemical References
  • Cytarabine
  • Cladribine
Topics
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Child, Preschool
  • Cladribine (administration & dosage)
  • Cytarabine (administration & dosage)
  • Histiocytosis, Langerhans-Cell (diagnostic imaging, drug therapy)
  • Humans
  • Infant
  • Infant, Newborn
  • Infusions, Intravenous
  • Radiography
  • Recurrence
  • Survival Rate

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