Which of the following drugs is used for the treatment of refractory histiocytosis – (AIIMS May 2013)
|A||High dose methotrexate|
|B||High dose cytarabine|
Treatment of LCH
a. Single system disease
i. The clinical course of single system disease is usually benign with a high chance of spontaneous remission.
ii. Therefore, treatment should be minimal and should be directed at arresting the progression of a bone lesion that could result in permanent damage before it resolves spontaneously.
iii. Curettage or less often low dose local radiotherapy may accomplish this.
b. Multisystem disease
i. It should be treated with systemic multiagent chemotherapy.
ii. Any one, of following two should be included in regimen -- i) Etoposide ii) vinblastin
o For urrresponsive disease following therapies are available :
i) Cyclosporine/antithymocyte globulin ii) Imatinib
iii) 2-chloro deoryadenosine (C ladribine) iv) Stem cell transplantation.