Methotrexate and cytarabine in adult LCH: High risk, high reward and maintenance free?

Lin et al. report the long-term follow-up of a phase II trial involving 95 adult patients with Langerhans cell histiocytosis (LCH), investigating the combination of methotrexate and cytarabine (MA). After a median follow-up of 6.5 years, the study showed high response rates, with 90% overall respons...

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Bibliographic Details
Published inBritish journal of haematology
Main Authors Abeykoon, Jithma P, Go, Ronald S, Azoulay, Levi-Dan, Haroche, Julien
Format Journal Article
LanguageEnglish
Published England 13.11.2024
Subjects
chemotherapy
histiocytosis
fixed duration treatment
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Summary:Lin et al. report the long-term follow-up of a phase II trial involving 95 adult patients with Langerhans cell histiocytosis (LCH), investigating the combination of methotrexate and cytarabine (MA). After a median follow-up of 6.5 years, the study showed high response rates, with 90% overall response; 55% of patients free from an event such as disease progression, poor response or death; and 93% of patients were alive, though nearly half experienced febrile neutropenia. This prospective study helps fill gaps in understanding adult LCH treatment, indicating that fixed-duration chemotherapy can yield durable responses despite its associated risks. It emphasizes the importance of personalized treatment decisions, considering both fixed-duration chemotherapy and continuous targeted agents based on patient and disease-specific factors. Commentary on: Lin et al. Long term follow-up of methotrexate and cytarabine in adult patients with Langerhans cell histiocytosis. Br J Haematol 2024 (Online ahead of print). doi: 10.1111/bjh.19830.
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ISSN:0007-1048
1365-2141
1365-2141
DOI:10.1111/bjh.19903