Treatment Options in Case of Reacitvation
Author(s): Euro Histio Net Work Group for LCH Guidelines (see introduction page), Created: 2011/05/20, last update: 2012/01/23
Reactivation of Single System Langerhans Cell Histiocytosis (SS-LCH)
The choice of treatment options is based on the same principles as for initial disease.
The options for reactivations of single system LCH (skin, bone, other) include:
I. Wait and watch approach
II. Local therapy (details see here)
III. Indomethacin for bony disease
IV. Vinblastine (VBL) + steroid (details see here)
Radiotherapy is no longer recommended due to the long-term sequelae.
In case of a multisystemic reactivation of a SS-LCH, treatment should follow the options for MS-LCH including systemic therapy.
Reactivation after Systemic Therapy
- If the reactivation is after completion of treatment, re-induction with VBL + steroid may be effective and there may be no need to switch to alternative therapy. If however, the disease is not responsive we suggest discussion with the reference centre for your country.
- If reactivation occurs while on treatment, 2nd line strategies should be discussed with your reference centre, taking into account disease severity and the respective risk for unfavorable outcome.