Journal
FRONTIERS IN PEDIATRICS
Volume 9, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fped.2021.672547
Keywords
juvenile xanthogranuloma; clinical characteristics; treatment; prognosis; system
Categories
Funding
- Capital Health Research and Development of Special Grants [2020-2-2093, 2020-2-1141]
- Special Fund of The Pediatric Medical Coordinated Development Center of Beijing Hospitals Authority [XTZD20180201]
- National Science and Technology Key Project [2017ZX09304029004]
- Beihang University Advanced Innovation Center for Big Data-Based Precision Medicine Plan [BHME-201912]
- Capital Medical University Advanced Innovation Center for Big Data-Based Precision Medicine Plan [BHME-201912]
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This study analyzed the clinical data of children with systemic juvenile xanthogranuloma in Beijing Children's Hospital and found that the chemotherapy regimen for Langerhans cell histiocytosis may be effective for treating systemic JXG. Central nervous system involvement may not impact overall survival, but serious permanent sequelae may occur.
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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