title: Excellent remission rates with limited toxicity in relapsed/refractory Langerhans cell histiocytosis with pulse dexamethasone and lenalidomide in children.
abstract: Refractory/relapsed Langerhans cell histiocytosis (LCH) has a difficult course with a guarded prognosis. We used a novel protocol including six cycles of pulse dexamethasone and lenalidomide in four children with LCH refractory to first-line agents and courses of cladribine and cytarabine or single-agent cladribine. All four children completed the protocol without any significant adverse effects and remain in complete and durable remission 15-18 months posttreatment. The novel protocol we propose for relapsed/refractory LCH is cost-effective and outpatient-based with durable remission and minimal toxicity. This is particularly suited for resource-limited settings.
authors.affiliation: Department of Pediatric Hematology, Oncology and BMT, Apollo Speciality Hospital, Chennai, Tamil Nadu, India.
authors.forename: Ramya
authors.initials: R
authors.lastname: Uppuluri
authors.affiliation: Department of Pediatric Hematology, Oncology and BMT, Apollo Speciality Hospital, Chennai, Tamil Nadu, India.
authors.forename: Sreejith
authors.initials: S
authors.lastname: Ramachandrakurup
authors.affiliation: Department of Pediatric Hematology, Oncology and BMT, Apollo Speciality Hospital, Chennai, Tamil Nadu, India.
authors.forename: Divya
authors.initials: D
authors.lastname: Subburaj
authors.affiliation: Department of Pediatric Hematology, Oncology and BMT, Apollo Speciality Hospital, Chennai, Tamil Nadu, India.
authors.forename: Atish
authors.initials: A
authors.lastname: Bakane
authors.affiliation: Department of Pediatric Hematology, Oncology and BMT, Apollo Speciality Hospital, Chennai, Tamil Nadu, India.
authors.forename: Revathi
authors.initials: R
authors.lastname: Raj
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002675:Child, Preschool; D003907:Dexamethasone / Q000627:therapeutic use*; D004351:Drug Resistance / Q000187:drug effects*; D004359:Drug Therapy, Combination; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007223:Infant; D000077269:Lenalidomide; D008297:Male; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D020533:Angiogenesis Inhibitors; D000893:Anti-Inflammatory Agents; D013792:Thalidomide; D003907:Dexamethasone; D000077269:Lenalidomide
keywords: Langerhans cell histiocytosis; lenalidomide; pulse dexamethasone