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Ono R, Sakamoto K, Kudo K, Sato A, Kudo K, Fujino H, Kawahara Y, Hashimoto H, Doi T, Yanagisawa R, Kawamata T, Miyazaki O, Nakazawa A, Ota Y, Kanegane H, Nakazawa Y, Horibe K, Saito AM, Manabe A, Usuki K, Kiyoi H, Morimoto A, Tojo A, Shioda Y. Phase II study in children and adults under 40 years with newly diagnosed Langerhans cell histiocytosis: protocol for an LCH-19-MSMFB clinical trial in Japan. BMJ Open 2024; 14:e084159. [PMID: 38910000 DOI: 10.1136/bmjopen-2024-084159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2024] Open
Abstract
INTRODUCTION Although the prognosis of Langerhans cell histiocytosis (LCH) is excellent, the high recurrence rate and permanent consequences, such as central diabetes insipidus and LCH-associated neurodegenerative diseases, remain to be resolved. Based on previous reports that patients with high-risk multisystem LCH show elevated levels of inflammatory molecules, we hypothesised that dexamethasone would more effectively suppress LCH-associated inflammation, especially in the central nervous system (CNS). We further hypothesised that intrathecal chemotherapy would effectively reduce CNS complications. We administer zoledronate to patients with multifocal bone LCH based on an efficacy report from a small case series. METHODS AND ANALYSIS This phase II study (labelled the LCH-19-MSMFB study) is designed to evaluate the significance of introducing dexamethasone and intrathecal chemotherapy for multisystem disease and zoledronate for multifocal bone disease in previously untreated, newly diagnosed children, adolescents (under 20 years) and adults under 40 years. The primary endpoint is the 3-year event-free survival rate by risk group of under 20 years and the 3-year event-free survival rate of 20 years and over. ETHICS AND DISSEMINATION This study was approved by the Central Review Board of the National Hospital Organisation Nagoya Medical Centre (Nagoya, Japan) on 21 January 2022 and was registered in the Japan Registry of Clinical Trials (https://jrct.niph.go.jp/en-latest-detail/jRCTs041210027). Written informed consent will be obtained from all patients and/or their guardians. TRIAL REGISTRATION NUMBER jRCTs041210027.
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Affiliation(s)
- Rintaro Ono
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
| | - Kenichi Sakamoto
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Ko Kudo
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Aki Sato
- Department of Hematology and Oncology, The Institute of Medical Science Research Hospital, The University of Tokyo, Tokyo, Japan
| | - Kazuko Kudo
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hisanori Fujino
- Department of Pediatrics, Osaka Red Cross Hospital, Osaka, Japan
| | - Yuta Kawahara
- Department of Pediatrics, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Hiroya Hashimoto
- Clinical Research Center, NHO Nagoya Medical Center, Nagoya, Japan
| | - Takehiko Doi
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Ryu Yanagisawa
- Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan
| | - Toyotaka Kawamata
- Department of Hematology and Oncology, The Institute of Medical Science Research Hospital, The University of Tokyo, Tokyo, Japan
- Department of Hematology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama, Japan
| | - Yasunori Ota
- Department of Diagnostic Pathology, The Institute of Medical Science Research Hospital, The University of Tokyo, Tokyo, Japan
| | - Hirokazu Kanegane
- Department of Child Health and Development, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yozo Nakazawa
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Keizo Horibe
- Clinical Research Center, NHO Nagoya Medical Center, Nagoya, Japan
| | - Akiko M Saito
- Clinical Research Center, NHO Nagoya Medical Center, Nagoya, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Hitoshi Kiyoi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akira Morimoto
- Department of Pediatrics, Jichi Medical University School of Medicine, Shimotsuke, Japan
- Department of Pediatrics, Showa Inan General Hospital, Komagane, Japan
| | - Arinobu Tojo
- Institute of Innovation, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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Papadakis V, Astigarraga I, van den Bos C, Donadieu J, Henter JI, Jacobs S, Lehrnbecher T, Munthe-Kaas MC, Naeije L, Nanduri V, Nguyen T, Nysom K, Pears J, Raciborska A, Sieni E, Svojgr K, Tzotzola V, Minkov M. The ECHO recommendations for dealing with vinblastine shortage affecting standard treatment of systemic Langerhans cell histiocytosis. Pediatr Blood Cancer 2024; 71:e30850. [PMID: 38185727 DOI: 10.1002/pbc.30850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Vassilios Papadakis
- Department of Pediatric Hematology-Oncology (TAO), Marianna V Vardinoyannis-ELPIDA Oncology Unit, Agia Sofia Children's Hospital, Athens, Greece
| | - Itziar Astigarraga
- Pediatric Oncology Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Pediatric Department, Hospital Universitario Cruces, Osakidetza, Barakaldo, Biscay, Spain
- Pediatric Department, Faculty of Medicine and Nursing, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Cor van den Bos
- Department of Hemato-oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jean Donadieu
- Centre de Référence des Histiocytoses Registre des histiocytoses, Service d'Hémato-Oncologie Pédiatrique Hopital Trousseau APHP Paris Sorbonne, Paris, France
| | - Jan-Inge Henter
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
- Department of Pediatrics, Astrid Lindgrens Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Sandra Jacobs
- Pediatric Hematology Oncology, University Hospital Leuven, Leuven, Belgium
| | - Thomas Lehrnbecher
- Department of Pediatrics, Division of Hematology, Oncology and Hemostaseology, Goethe University Frankfurt, Frankfurt/Main, Germany
| | | | - Leonie Naeije
- Department of Hemato-oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Vasanta Nanduri
- Department of Paediatrics, Watford General Hospital, Watford, UK
| | - Trung Nguyen
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Karsten Nysom
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jane Pears
- Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Anna Raciborska
- Department of Oncology and Surgical Oncology for Children and Youth, Institute of Mother and Child, Warsaw, Poland
| | - Elena Sieni
- Pediatric Hematology/Oncology Department, Meyer Children's University Hospital, Florence, Italy
| | - Karel Svojgr
- Department of Pediatric Hematology and Oncology, Charles University in Prague, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - Vasiliki Tzotzola
- Department of Pediatric Hematology-Oncology (TAO), Marianna V Vardinoyannis-ELPIDA Oncology Unit, Agia Sofia Children's Hospital, Athens, Greece
| | - Milen Minkov
- CCRI, St. Anna Kinderkrebsforschung, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
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