A Multicenter Study of Patients with Multisystem Langerhans Cell Histiocytosis Who Develop Secondary Hemophagocytic Lymphohistiocytosis

BACKGROUND: Langerhans cell histiocytosis (LCH) is a rare myeloid neoplasm characterized by the presence of abnormal CD1a-positive (CD1a(+))/CD207(+) histiocytes. Hemophagocytic lymphohistiocytosis (HLH) represents a spectrum of hyperinflammatory syndromes typified by the dysregulated activation of...

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Autores: Chellapandian D, Hines MR, Zhang R, Jeng M, van den Bos C, Santa-Maria Lopez V, Lehmberg K, Sieni E, Wang Y, Nakano T, Williams JA, Fustino NJ, Astigarraga I, Dunkel IJ, Abla O, van Halteren AGS, Pei D, Cheng C, Weitzman S, Sung L, Nichols KE
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p15460
Acceso en línea:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=15460
Access Level:acceso abierto
Palabra clave:ferritin
hemophagocytic lymphohistiocytosis (HLH)
hyperinflammation
Langerhans cell histiocytosis (LCH)
soluble interleukin 2 receptor (soluble CD25)
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spelling A Multicenter Study of Patients with Multisystem Langerhans Cell Histiocytosis Who Develop Secondary Hemophagocytic LymphohistiocytosisChellapandian DHines MRZhang RJeng Mvan den Bos CSanta-Maria Lopez VLehmberg KSieni EWang YNakano TWilliams JAFustino NJAstigarraga IDunkel IJAbla Ovan Halteren AGSPei DCheng CWeitzman SSung LNichols KEferritinhemophagocytic lymphohistiocytosis (HLH)hyperinflammationLangerhans cell histiocytosis (LCH)soluble interleukin 2 receptor (soluble CD25)BACKGROUND: Langerhans cell histiocytosis (LCH) is a rare myeloid neoplasm characterized by the presence of abnormal CD1a-positive (CD1a(+))/CD207(+) histiocytes. Hemophagocytic lymphohistiocytosis (HLH) represents a spectrum of hyperinflammatory syndromes typified by the dysregulated activation of the innate and adaptive immune systems. Patients with LCH, particularly those with multisystem (MS) involvement, can develop severe hyperinflammation mimicking that observed in HLH. Nevertheless, to the authors' knowledge, little is known regarding the prevalence, timing, risk factors for development, and outcomes of children and young adults who develop HLH within the context of MS-LCH (hereafter referred to LCH-associated HLH). METHODS: To gain further insights, the authors conducted a retrospective, multicenter study and collected data regarding all patients diagnosed with MS-LCH between 2000 and 2015. RESULTS: Of 384 patients with MS-LCH, 32 were reported by their primary providers to have met the diagnostic criteria for HLH, yielding an estimated 2-year cumulative incidence of 9.3% +/- 1.6%. The majority of patients developed HLH at or after the diagnosis of MS-LCH, and nearly one-third (31%) had evidence of an intercurrent infection. Patient age <2 years at the time of diagnosis of LCH; female sex; LCH involvement of the liver, spleen, and hematopoietic system; and a lack of bone involvement each were found to be independently associated with an increased risk of LCH-associated HLH. Patients with MS-LCH who met the criteria for HLH had significantly poorer 5-year survival compared with patients with MS-LCH who did not meet the criteria for HLH (69% vs 97%; P < .0001). CONCLUSIONS: Given its inferior prognosis, further efforts are warranted to enhance the recognition and optimize the treatment of patients with LCH-associated HLH. (C) 2018 American Cancer Society.WILEY2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=15460CANCERISSN: 0008543XISSNe: 10970142reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuInglésinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p154602026-05-27T12:37:41Z
dc.title.none.fl_str_mv A Multicenter Study of Patients with Multisystem Langerhans Cell Histiocytosis Who Develop Secondary Hemophagocytic Lymphohistiocytosis
title A Multicenter Study of Patients with Multisystem Langerhans Cell Histiocytosis Who Develop Secondary Hemophagocytic Lymphohistiocytosis
spellingShingle A Multicenter Study of Patients with Multisystem Langerhans Cell Histiocytosis Who Develop Secondary Hemophagocytic Lymphohistiocytosis
Chellapandian D
ferritin
hemophagocytic lymphohistiocytosis (HLH)
hyperinflammation
Langerhans cell histiocytosis (LCH)
soluble interleukin 2 receptor (soluble CD25)
title_short A Multicenter Study of Patients with Multisystem Langerhans Cell Histiocytosis Who Develop Secondary Hemophagocytic Lymphohistiocytosis
title_full A Multicenter Study of Patients with Multisystem Langerhans Cell Histiocytosis Who Develop Secondary Hemophagocytic Lymphohistiocytosis
title_fullStr A Multicenter Study of Patients with Multisystem Langerhans Cell Histiocytosis Who Develop Secondary Hemophagocytic Lymphohistiocytosis
title_full_unstemmed A Multicenter Study of Patients with Multisystem Langerhans Cell Histiocytosis Who Develop Secondary Hemophagocytic Lymphohistiocytosis
title_sort A Multicenter Study of Patients with Multisystem Langerhans Cell Histiocytosis Who Develop Secondary Hemophagocytic Lymphohistiocytosis
dc.creator.none.fl_str_mv Chellapandian D
Hines MR
Zhang R
Jeng M
van den Bos C
Santa-Maria Lopez V
Lehmberg K
Sieni E
Wang Y
Nakano T
Williams JA
Fustino NJ
Astigarraga I
Dunkel IJ
Abla O
van Halteren AGS
Pei D
Cheng C
Weitzman S
Sung L
Nichols KE
author Chellapandian D
author_facet Chellapandian D
Hines MR
Zhang R
Jeng M
van den Bos C
Santa-Maria Lopez V
Lehmberg K
Sieni E
Wang Y
Nakano T
Williams JA
Fustino NJ
Astigarraga I
Dunkel IJ
Abla O
van Halteren AGS
Pei D
Cheng C
Weitzman S
Sung L
Nichols KE
author_role author
author2 Hines MR
Zhang R
Jeng M
van den Bos C
Santa-Maria Lopez V
Lehmberg K
Sieni E
Wang Y
Nakano T
Williams JA
Fustino NJ
Astigarraga I
Dunkel IJ
Abla O
van Halteren AGS
Pei D
Cheng C
Weitzman S
Sung L
Nichols KE
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv ferritin
hemophagocytic lymphohistiocytosis (HLH)
hyperinflammation
Langerhans cell histiocytosis (LCH)
soluble interleukin 2 receptor (soluble CD25)
topic ferritin
hemophagocytic lymphohistiocytosis (HLH)
hyperinflammation
Langerhans cell histiocytosis (LCH)
soluble interleukin 2 receptor (soluble CD25)
description BACKGROUND: Langerhans cell histiocytosis (LCH) is a rare myeloid neoplasm characterized by the presence of abnormal CD1a-positive (CD1a(+))/CD207(+) histiocytes. Hemophagocytic lymphohistiocytosis (HLH) represents a spectrum of hyperinflammatory syndromes typified by the dysregulated activation of the innate and adaptive immune systems. Patients with LCH, particularly those with multisystem (MS) involvement, can develop severe hyperinflammation mimicking that observed in HLH. Nevertheless, to the authors' knowledge, little is known regarding the prevalence, timing, risk factors for development, and outcomes of children and young adults who develop HLH within the context of MS-LCH (hereafter referred to LCH-associated HLH). METHODS: To gain further insights, the authors conducted a retrospective, multicenter study and collected data regarding all patients diagnosed with MS-LCH between 2000 and 2015. RESULTS: Of 384 patients with MS-LCH, 32 were reported by their primary providers to have met the diagnostic criteria for HLH, yielding an estimated 2-year cumulative incidence of 9.3% +/- 1.6%. The majority of patients developed HLH at or after the diagnosis of MS-LCH, and nearly one-third (31%) had evidence of an intercurrent infection. Patient age <2 years at the time of diagnosis of LCH; female sex; LCH involvement of the liver, spleen, and hematopoietic system; and a lack of bone involvement each were found to be independently associated with an increased risk of LCH-associated HLH. Patients with MS-LCH who met the criteria for HLH had significantly poorer 5-year survival compared with patients with MS-LCH who did not meet the criteria for HLH (69% vs 97%; P < .0001). CONCLUSIONS: Given its inferior prognosis, further efforts are warranted to enhance the recognition and optimize the treatment of patients with LCH-associated HLH. (C) 2018 American Cancer Society.
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=15460
url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=15460
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv CANCER
ISSN: 0008543X
ISSNe: 10970142
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname:Fundació Sant Joan de Déu
instname_str Fundació Sant Joan de Déu
reponame_str r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
collection r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
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