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Twelve months of vinblastine and prednisone, rather than six, meant fewer children's Langerhans cell histiocytosis came back, and mortality in the highest-risk children fell to a fraction of what it had been.
International randomised trial of the Histiocyte Society in children with multisystem Langerhans cell histiocytosis: patients with risk-organ involvement were randomised to vinblastine and prednisone with or without methotrexate, and those without risk-organ involvement to six or twelve months of treatment.
Methotrexate added no benefit, while twelve months of therapy roughly halved the five-year reactivation rate compared with six months (about 37 versus 54 percent). Mortality in risk-organ-positive patients fell to about 15 percent with early switching of non-responders to salvage. Twelve months of vinblastine and prednisone became the international standard.
Children with multisystem LCH receive a year of vinblastine and prednisone, and those in whom the disease does not respond quickly are switched early to salvage therapy.
Shares Single-system Langerhans cell histiocytosis (bone, skin or one other organ), Multisystem Langerhans cell histiocytosis (with or without risk-organ involvement), Blood.
Shares Single-system Langerhans cell histiocytosis (bone, skin or one other organ), Blood.
Shares LCH-III, Vinblastine.
Shares LCH-III, Single-system Langerhans cell histiocytosis (bone, skin or one other organ), Multisystem Langerhans cell histiocytosis (with or without risk-organ involvement), Vinblastine.
Shares Single-system Langerhans cell histiocytosis (bone, skin or one other organ), Multisystem Langerhans cell histiocytosis (with or without risk-organ involvement).
Shares Single-system Langerhans cell histiocytosis (bone, skin or one other organ), Multisystem Langerhans cell histiocytosis (with or without risk-organ involvement).
Shares Single-system Langerhans cell histiocytosis (bone, skin or one other organ), Multisystem Langerhans cell histiocytosis (with or without risk-organ involvement).
Shares Single-system Langerhans cell histiocytosis (bone, skin or one other organ), Multisystem Langerhans cell histiocytosis (with or without risk-organ involvement).