Langerhans cell histiocytosis with central nervous system involvement: follow-up by FDG-PET during treatment with cladribine.
The prognosis of patients with Langerhans cell histiocytosis (LCH) involving the central nervous system (CNS) is generally poor, despite reports of clinical responses to chemotherapy, surgery, and radiation. We report on a patient with a 20-year history of relapsing multisystem LCH who developed progressive neuropsychiatric symptoms, including diplopia, ataxia, and mental deterioration. There was a regression of lesions in the brain stem and cerebellum following chemotherapy with cladribine (2-CdA) as evidenced by positron emission tomography (PET) scans. In conclusion, our experience is encouraging for the use of cladribine in CNS LCH. PET may be a useful modality for the monitoring of CNS disease activity in LCH and provides additional information in comparison with NMR imaging.
Department of Internal Medicine-Hematooncology, Masaryk University Hospital, Brno, Czech Republic. buchlert@seznam.cz
Tomas
T
Büchler
Libor
L
Cervinek
Otakar
O
Belohlavek
Iva
I
Kantorova
Marek
M
Mechl
Tomas
T
Nebesky
Jiri
J
Vorlicek
Zdenek
Z
Adam
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001927:Brain Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D017338:Cladribine / Q000627:therapeutic use*; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006646:Histiocytosis, Langerhans-Cell / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography
D000970:Antineoplastic Agents; D019788:Fluorodeoxyglucose F18; D017338:Cladribine