What is the role of intense MACOP-B therapy in the treatment of Langerhans cell histiocytosis (LCH)?

Updated: Jun 12, 2020
  • Author: Christopher R Shea, MD; Chief Editor: William D James, MD  more...
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Answer

A paucity of clinical trials for the treatment of LCH in adults has lead to the report by Derenzini and colleagues of a monocentric, retrospective study on the use of intense MACOP-B therapy (a common therapeutic regimen in aggressive non-Hodgkin lymphoma) without continued maintenance therapy, in the treatment of adults with LCH. [57]

In this study, 7 patients were treated with MACOP-B (methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin) weekly for 12 weeks. A retrospective analysis of these patients showed a complete response (defined as no evidence of active disease, plus a regression of signs and symptoms at physical examination and on imaging) in all 7 patients, although 3 patients subsequently had reactivation of their disease. Taken together, the authors conclude that more intense initial therapy may induce a better disease response in adults than alternative regimens that induce partial response to induction chemotherapy followed by a maintenance regimen. [57] However, these results require more formal evaluation.


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