Rituximab therapy for patients with Langerhans cell histiocytosis-associated neurologic dysfunction

Pediatr Hematol Oncol. 2018 Oct-Nov;35(7-8):427-433. doi: 10.1080/08880018.2018.1555297. Epub 2018 Dec 31.

Abstract

Objective: Since patients with langerhans cell histiocytosis and neurologic dysfunction (LCH-ND) often have incomplete treatment responses we sought a new treatment regimen. Because of clinical benefit from rituximab in multiple sclerosis patients with neurodegeneration, we evaluated its use in patients with LCH-ND.

Participants: Eight LCH-ND patients who had failed prior therapies.

Methods: Charts of the 8 patients treated with rituximab were reviewed. Signs/symptoms and MRI responses were assessed.

Results: Seven of eight patients experienced some clinical improvement: gait abnormalities and tremors in four children, proprioceptive deficits in 2, and dysarthria/dysphagia in 2. Five of eight patients demonstrated improvement in intellectual/behavioral/psychological symptoms.

Conclusion: These findings suggest that prospective studies are warranted to define safety and efficacy of rituximab for patients with LCH-ND.

Keywords: Langerhans cell histiocytosis; Rituximab; neurologic dysfunction.

MeSH terms

  • Adult
  • Child
  • Child, Preschool
  • Female
  • Histiocytosis, Langerhans-Cell / drug therapy*
  • Histiocytosis, Langerhans-Cell / pathology
  • Histiocytosis, Langerhans-Cell / physiopathology
  • Humans
  • Infant
  • Male
  • Nervous System Diseases / drug therapy*
  • Nervous System Diseases / pathology
  • Nervous System Diseases / physiopathology
  • Rituximab / administration & dosage*
  • Rituximab / adverse effects

Substances

  • Rituximab