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Lian H, Wei A, He L, Yang Y, Ma H, Zhang L, Guan Y, Zhang Q, Wang D, Li Z, Zhang R, Wang T. Clinical Analysis of Pediatric Systemic Juvenile Xanthogranulomas: A Retrospective Single-Center Study. Front Pediatr 2021; 9:672547. [PMID: 34178890 PMCID: PMC8222597 DOI: 10.3389/fped.2021.672547] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/18/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate the clinical characteristics, treatment, and prognosis of children with systemic juvenile xanthogranuloma (JXG). Methods: Clinical data of children with JXG who were hospitalized in Beijing Children's Hospital, Capital Medical University, from January 2012 to December 2019 were retrospectively analyzed, including clinical manifestations, laboratory determinations, treatment, and prognosis of the children. Patients were treated with vindesine + prednisone as the first-line treatment and cytarabine + vindesine + dexamethasone ± cladribine as the second-line treatment. Results: Ten patients, including 8 males and 2 females, with a median of onset age of 1.95 (0.80-7.30) years, exhibited multi-system dysfunction. The median age of diagnosis was 2.45 (1.30-12.10) years. The most common location of extracutaneous lesions was the central nervous system (6 cases), followed by the lung (5 cases) and bone (4 cases). Nine patients underwent first-line chemotherapy, and 6 patients underwent second-line chemotherapy, including 5 patients with poorly controlled disease after first-line treatment. The median observation time was 29 (3-115) months. Nine patients survived, whereas one patient died of respiratory failure caused by pulmonary infection. At the end of follow-up, 7 patients were in active disease (AD)/regression state (AD-better), and 2 patients were in an AD/stable state (AD-stable). Three patients had permanent sequelae, mainly central diabetes insipidus. The rates of response to the first-line treatment and the second-line treatment were 40.0 and 66.7% respectively. Conclusion: The chemotherapy protocol for Langerhans cell histiocytosis (LCH) may be effective for patients with systemic JXG. Central nervous system involvement may not impact overall survival, but serious permanent sequelae may occur.
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Affiliation(s)
- Hongyun Lian
- Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, Beijing, China.,National Key Discipline of Pediatrics, Capital Medical University, Beijing, China.,Key Laboratory of Major Disease in Children, Ministry of Education, Beijing, China.,Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Ang Wei
- Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, Beijing, China.,National Key Discipline of Pediatrics, Capital Medical University, Beijing, China.,Key Laboratory of Major Disease in Children, Ministry of Education, Beijing, China.,Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Lejian He
- Department of Pathology, Beijing Children's Hospital Affiliated With Capital Medical University, National Center for Children's Health, Beijing, China
| | - Ying Yang
- Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, Beijing, China.,National Key Discipline of Pediatrics, Capital Medical University, Beijing, China.,Key Laboratory of Major Disease in Children, Ministry of Education, Beijing, China.,Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Honghao Ma
- Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, Beijing, China.,National Key Discipline of Pediatrics, Capital Medical University, Beijing, China.,Key Laboratory of Major Disease in Children, Ministry of Education, Beijing, China.,Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Liping Zhang
- Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, Beijing, China.,National Key Discipline of Pediatrics, Capital Medical University, Beijing, China.,Key Laboratory of Major Disease in Children, Ministry of Education, Beijing, China.,Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yitong Guan
- Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, Beijing, China.,National Key Discipline of Pediatrics, Capital Medical University, Beijing, China.,Key Laboratory of Major Disease in Children, Ministry of Education, Beijing, China.,Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Qing Zhang
- National Key Discipline of Pediatrics, Capital Medical University, Beijing, China.,Key Laboratory of Major Disease in Children, Ministry of Education, Beijing, China.,Hematologic Disease Laboratory, Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, Beijing, China.,Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Dong Wang
- Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, Beijing, China.,National Key Discipline of Pediatrics, Capital Medical University, Beijing, China.,Key Laboratory of Major Disease in Children, Ministry of Education, Beijing, China.,Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhigang Li
- National Key Discipline of Pediatrics, Capital Medical University, Beijing, China.,Key Laboratory of Major Disease in Children, Ministry of Education, Beijing, China.,Hematologic Disease Laboratory, Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, Beijing, China.,Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Rui Zhang
- Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, Beijing, China.,National Key Discipline of Pediatrics, Capital Medical University, Beijing, China.,Key Laboratory of Major Disease in Children, Ministry of Education, Beijing, China.,Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Tianyou Wang
- Hematology Center, Beijing Key Laboratory of Pediatric Hematology Oncology, Beijing, China.,National Key Discipline of Pediatrics, Capital Medical University, Beijing, China.,Key Laboratory of Major Disease in Children, Ministry of Education, Beijing, China.,Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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5
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Cohen Aubart F, Haroche J, Emile JF, Charlotte F, Barete S, Schleinitz N, Donadieu J, Amoura Z. [Rosai-Dorfman disease: Diagnosis and therapeutic challenges]. Rev Med Interne 2018; 39:635-640. [PMID: 29501513 DOI: 10.1016/j.revmed.2018.02.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 01/28/2018] [Accepted: 02/04/2018] [Indexed: 12/24/2022]
Abstract
Rosai-Dorfman disease (RDD) was first described by the French pathologist Paul Destombes in 1965. It frequently affects children or young adults and is characterized by the presence of large histiocytes with emperipolesis. More than 50 years after this first description, the pathogenesis of this rare disease is still poorly understood. The revised classification of histiocytoses published in 2016 identified various forms of RDD, from familial RDD to IgG4-associated RDD. Almost 90% of the patients with RDD have cervical lymph nodes involvement although all the organs may virtually be involved. Outcomes are typically favorable. Treatments may be necessary in case of compression or obstruction, and are not well codified. The main therapeutic strategies rely on surgery, radiotherapy, steroids, immunosuppressive drugs or interferon-alpha and cladribine.
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Affiliation(s)
- F Cohen Aubart
- Service de médecine interne 2, centre national de référence maladies systémiques rares et histiocytoses, institut e3M, hôpital de la Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Université Paris-VI, Sorbonnes-Universités, 75013 Paris, France.
| | - J Haroche
- Service de médecine interne 2, centre national de référence maladies systémiques rares et histiocytoses, institut e3M, hôpital de la Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Université Paris-VI, Sorbonnes-Universités, 75013 Paris, France
| | - J-F Emile
- Département d'anatomo-pathologie, EA4340, hôpital Ambroise-Paré, université de Versailles, AP-HP, 92104 Boulogne, France
| | - F Charlotte
- Université Paris-VI, Sorbonnes-Universités, 75013 Paris, France; Service d'anatomo-pathologie, hôpital de la Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - S Barete
- UF de dermatologie, hôpital de la Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - N Schleinitz
- Service de médecine interne, hôpital de la Timone et Aix-Marseille université, AP-HM, 13385 Marseille, France
| | - J Donadieu
- Service d'hématologie, hôpital Trousseau, AP-HP, 75012 Paris, France
| | - Z Amoura
- Service de médecine interne 2, centre national de référence maladies systémiques rares et histiocytoses, institut e3M, hôpital de la Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Université Paris-VI, Sorbonnes-Universités, 75013 Paris, France
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