Clinical features and prognostic factors of pediatric Langerhans cell histiocytosis: a single-center retrospective study

PurposeTo retrospectively evaluate the clinical features and prognostic factors of pediatric LCH patients treated in a single center of China.MethodsPediatric LCH cases were treated following the SD-LCH protocol at the Affiliated Provincial Hospital of Shandong First Medical University in Jinan, Chi...

Full description

Saved in:
Bibliographic Details
Main Authors: Yunfeng Lu, Liying Liu, Qi Wang, Bingju Liu, Ping Zhao, Guotao Guan, Yunpeng Dai
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2024.1452003/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849774905138085888
author Yunfeng Lu
Liying Liu
Qi Wang
Bingju Liu
Ping Zhao
Guotao Guan
Yunpeng Dai
author_facet Yunfeng Lu
Liying Liu
Qi Wang
Bingju Liu
Ping Zhao
Guotao Guan
Yunpeng Dai
author_sort Yunfeng Lu
collection DOAJ
description PurposeTo retrospectively evaluate the clinical features and prognostic factors of pediatric LCH patients treated in a single center of China.MethodsPediatric LCH cases were treated following the SD-LCH protocol at the Affiliated Provincial Hospital of Shandong First Medical University in Jinan, China. An analysis was conducted on 82 recently identified LCH cases to retrospectively evaluate the initial symptoms, therapeutic alternatives, and extended results. Follow-ups were conducted until July 31, 2023.ResultsThe median age at diagnosis was 2 (0.25–12) years. 42 (51.2%) were SS-LCH, and 40 (48.8%) were MS-LCH. The most common organ involved was bone (82.9%). Over the 16-year follow-up period, the 5-year EFS and OS rates were 75.2 ± 5% and 90.9 ± 3.3%, respectively. The cumulative reactivation rate was 23.2%. The 5-year EFS rate in SS-LCH and MS-LCH patients were 90.2 ± 4.6% and 58.8 ± 8.3%, and the 5-year OS rate in SS-LCH and MS-LCH patients were 90.2 ± 4.6% and 81.2 ± 6.5%, respectively. The 5-year OS and EFS rate in RO+ LCH and RO− LCH patients were 79.5 ± 7.5%, 53.8 ± 9.6% and 87.5 ± 11.7%, 76.2 ± 14.8%, insignificantly. Multivariate Cox regression showed that liver involvement predicted poor EFS and hematological system involvement was an independent prognostic factor for OS. Detection of the BRAFV600E mutation and targeted therapy significantly improved the prognosis post-2017.ConclusionLiver or hematological system involvement indicates a poor prognosis, and the SD-LCH protocol improves prognosis for pediatric LCH patients.
format Article
id doaj-art-0d4af3cf53ab4f94b3deaf663ae50dc9
institution DOAJ
issn 2296-858X
language English
publishDate 2025-01-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj-art-0d4af3cf53ab4f94b3deaf663ae50dc92025-08-20T03:01:35ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011110.3389/fmed.2024.14520031452003Clinical features and prognostic factors of pediatric Langerhans cell histiocytosis: a single-center retrospective studyYunfeng LuLiying LiuQi WangBingju LiuPing ZhaoGuotao GuanYunpeng DaiPurposeTo retrospectively evaluate the clinical features and prognostic factors of pediatric LCH patients treated in a single center of China.MethodsPediatric LCH cases were treated following the SD-LCH protocol at the Affiliated Provincial Hospital of Shandong First Medical University in Jinan, China. An analysis was conducted on 82 recently identified LCH cases to retrospectively evaluate the initial symptoms, therapeutic alternatives, and extended results. Follow-ups were conducted until July 31, 2023.ResultsThe median age at diagnosis was 2 (0.25–12) years. 42 (51.2%) were SS-LCH, and 40 (48.8%) were MS-LCH. The most common organ involved was bone (82.9%). Over the 16-year follow-up period, the 5-year EFS and OS rates were 75.2 ± 5% and 90.9 ± 3.3%, respectively. The cumulative reactivation rate was 23.2%. The 5-year EFS rate in SS-LCH and MS-LCH patients were 90.2 ± 4.6% and 58.8 ± 8.3%, and the 5-year OS rate in SS-LCH and MS-LCH patients were 90.2 ± 4.6% and 81.2 ± 6.5%, respectively. The 5-year OS and EFS rate in RO+ LCH and RO− LCH patients were 79.5 ± 7.5%, 53.8 ± 9.6% and 87.5 ± 11.7%, 76.2 ± 14.8%, insignificantly. Multivariate Cox regression showed that liver involvement predicted poor EFS and hematological system involvement was an independent prognostic factor for OS. Detection of the BRAFV600E mutation and targeted therapy significantly improved the prognosis post-2017.ConclusionLiver or hematological system involvement indicates a poor prognosis, and the SD-LCH protocol improves prognosis for pediatric LCH patients.https://www.frontiersin.org/articles/10.3389/fmed.2024.1452003/fullLangerhans cell histiocytosischemotherapypediatric oncologyBRAFV600E inhibitorprognosis
spellingShingle Yunfeng Lu
Liying Liu
Qi Wang
Bingju Liu
Ping Zhao
Guotao Guan
Yunpeng Dai
Clinical features and prognostic factors of pediatric Langerhans cell histiocytosis: a single-center retrospective study
Frontiers in Medicine
Langerhans cell histiocytosis
chemotherapy
pediatric oncology
BRAFV600E inhibitor
prognosis
title Clinical features and prognostic factors of pediatric Langerhans cell histiocytosis: a single-center retrospective study
title_full Clinical features and prognostic factors of pediatric Langerhans cell histiocytosis: a single-center retrospective study
title_fullStr Clinical features and prognostic factors of pediatric Langerhans cell histiocytosis: a single-center retrospective study
title_full_unstemmed Clinical features and prognostic factors of pediatric Langerhans cell histiocytosis: a single-center retrospective study
title_short Clinical features and prognostic factors of pediatric Langerhans cell histiocytosis: a single-center retrospective study
title_sort clinical features and prognostic factors of pediatric langerhans cell histiocytosis a single center retrospective study
topic Langerhans cell histiocytosis
chemotherapy
pediatric oncology
BRAFV600E inhibitor
prognosis
url https://www.frontiersin.org/articles/10.3389/fmed.2024.1452003/full
work_keys_str_mv AT yunfenglu clinicalfeaturesandprognosticfactorsofpediatriclangerhanscellhistiocytosisasinglecenterretrospectivestudy
AT liyingliu clinicalfeaturesandprognosticfactorsofpediatriclangerhanscellhistiocytosisasinglecenterretrospectivestudy
AT qiwang clinicalfeaturesandprognosticfactorsofpediatriclangerhanscellhistiocytosisasinglecenterretrospectivestudy
AT bingjuliu clinicalfeaturesandprognosticfactorsofpediatriclangerhanscellhistiocytosisasinglecenterretrospectivestudy
AT pingzhao clinicalfeaturesandprognosticfactorsofpediatriclangerhanscellhistiocytosisasinglecenterretrospectivestudy
AT guotaoguan clinicalfeaturesandprognosticfactorsofpediatriclangerhanscellhistiocytosisasinglecenterretrospectivestudy
AT yunpengdai clinicalfeaturesandprognosticfactorsofpediatriclangerhanscellhistiocytosisasinglecenterretrospectivestudy