|Table of Contents|

Clinical features,treatment and prognosis of eosinophilic granuloma of bone in children(33 cases)

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 04
Page:
718-725
Research Field:
Publishing date:

Info

Title:
Clinical features,treatment and prognosis of eosinophilic granuloma of bone in children(33 cases)
Author(s):
NIU Xueqiang; QU Yuran; WEN Long; LIU Yang
Department of Pediatric Orthopaedics,the Third Affiliated Hospital of Zhengzhou University,Henan Zhengzhou 450000,China.
Keywords:
eosinophilic granuloma; bone; children; treatment; prognosis
PACS:
R738
DOI:
10.3969/j.issn.1672-4992.2023.04.024
Abstract:
Objective:To investigate the clinical features,treatment and prognosis of eosinophilic granuloma of bone(EG)in children.Methods:From January 2004 to June 2021,33 patients with bone EG in the department of pediatric orthopaedics,of our hospital were retrospectively analyzed.They were divided into two groups:Single focus involvement group and multi-focus involvement group.The general data,clinical features,treatment and outcome of the patients were collected.The event-free survival(EFS) rate of the whole group and the two groups was estimated by Kaplan-Meier method,and the logarithmic rank test(log-rank test)was used to compare the two groups.Results:There were 25 males(76%)and 8 females(24%).The median age at the time of diagnosis was 2.1 years(0.2~7 years).The main complaints were local bone mass,pain and functional limitation.Among them,the limbs were the most involved,followed by the spine,pelvis and skull.In the 21 cases of the single focus group,12 cases underwent local resection with or without local steroids,7 cases underwent operation and postoperative systemic chemotherapy with or without local steroids,and 2 cases received systemic chemotherapy after biopsy.In the muliti-fous groups,3 patients received surgery combined with systemic chemotherapy,and 9 patients recived systemic chemotherapy after biopsy.There was 1 case of recurrence in the single focus group and 5 cases in the multi-focus group.There was no death in both groups.The EFS rate in the single lesion group was higher than that in the multi-focus group,and the difference was statistically significant (P=0.009).The median follow-up time was 7.3 years(0.8~17.5 years).Conclusion:The risk of bone EG is low.There is no obvious life threat,and the prognosis is good.The patients with single focus and multiple lesions had less recurrence or progression,good surgical effect and high cure rate,and the chemotherapy effect of patients with multiple lesions was better.Active treatment and long-term follow-up can reduce the occurrence of complications and improve the quality of life of patients.

References:

［1］RICCARDO H,MILEN M,ITZIAR A,et al.Langerhans cell histiocytosis(LCH):Guidelines for diagnosis,clinical work-up,and treatment for patients till the age of 18 years［J］.Pediatric Blood & Cancer,2013,60(2):175-184.
［2］WU Shenghua.Introduction of guidelines on evaluation and treatment of Langerhans cell histiocytosis［J］.Chinese Journal of Pediatrics,2012,50(2):155-158.
［3］RODRIGUEZ-GALINDO C,ALLEN CE.Langerhans cell histiocytosis［J］.Blood,2020,135(16):1319-1331.
［4］MORIMOTO A,SHIODA Y,IMAMURA T,et al.Intensification of induction therapy and prolongation of maintenance therapy did not improve the outcome of pediatric Langerhans cell histiocytosis with single-system multifocal bone lesions:Results of the Japan Langerhans cell histiocytosis study group-02 protocol study［J］.International Journal of Hematology,2018,108(2):192-198.
［5］TUYSUZ G,YILDIZ I,OZDEMIR N,et al.Langerhans cell histiocytosis:Single center experience of 25 years［J］.Mediterranean Journal of Hematology and Infectious Diseases,2019,11(1):e2019035.
［6］徐强,李家祥,韩冬煦,等.骨嗜酸性肉芽肿16例误诊分析及诊治策略［J］.临床误诊误治,2020,33(08):13-17. XU Qiang,LI Jiaxiang,HAN Dongxu,et al.Misdiagnosis analysis and diagnosis strategy of 16 cases of eosinophilic granuloma of bone［J］.Clinical Misdiagnosis and Mistreatment,2020,33(08):13-17.
［7］SINGH J,RAIAKULASINGAM R,SAIFUDDIN A.Langerhans cell histiocytosis of the shoulder girdle,pelvis and extremities:A review of radiographic and MRI features in 85 cases［J］.Skeletal Radiology,2020,49(12):1925-1937.
［8］利洪艺,温丽丽,王博,等.成人孤立性骨嗜酸性肉芽肿45例临床分析［J］.中山大学学报(医学版),2018,39(06):904-911. LI Hongyi,WEN Lili,WANG Bo,et al.Clinical analysis of 45 cases of adult solitary eosinophilic granuloma of bone［J］.Journal of Sun Yat-Sen University(Medical Edition),2018,39(06):904-911.
［9］高喆,王刚,何俊平,等.儿童颅骨嗜酸性肉芽肿51例［J］.中华实用儿科临床杂志,2014,29(15):1193-1196. GAO Zhe,WANG Gang,HE Junping,et al.51 cases of eosinophilic granuloma of skull in children［J］.Chinese Journal of Practical Pediatrics,2014,29(15):1193-1196.
［10］PICARSIC J,JAFFE R.Nosology and pathology of langerhans cell histiocytosis［J］.Hematology/Oncology Clinics of North America,2015,29(5):799-823.
［11］SCHWARTZ Z,BENDER A,MAGRO CM.Solitary congenital langerhans cell histiocytoma:A pattern of benign,spontaneous regression in patients with single lesion disease［J］.Pediatric Dermatology,2020,37(6):1009-1013.
［12］JEZIERSKA M,STEFANOWICZ J,ROMANOWICZ G,et al.Langerhans cell histiocytosis in children-a disease with many faces.Recent advances in pathogenesis,diagnostic examinations and treatment［J］.Postepy Dermatologii I Alergologii,2018,35(1):6-17.
［13］KROOKS J,MINKOV M,WEATHERALL AG.Langerhans cell histiocytosis in children:History,classification,pathobiology,clinical manifestations,and prognosis［J］.Journal of the American Academy of Dermatology,2018,78(6):1035-1044.
［14］唐雪,高举.儿童朗格罕细胞组织细胞增生症发病机制及治疗进展［J］.中华儿科杂志,2019，57(08):650-653. TANG Xue,GAO Ju.Pathogenesis and treatment of Langerhans cell histiocytosis in children［J］.Chinese Journal of Pediatrics,2019,57(08):650-653.
［15］HERITIER S,EMILE JF,BARKAOUI MA,et al.BRAF mutation correlates with high-risk langerhans cell histiocytosis and increased resistance to first-line therapy［J］.Official Journal of the American Society of Clinical Oncology,2016,34(25):3023-3030.
［16］范枝俏,潘耀柱,刘萍,等.朗格汉斯细胞组织细胞增生症的研究进展［J］.中国实验血液学杂志,2020,28(01):354-358. FAN Zhiqiao,PAN Yaozhu,LIU Ping,et al.Research progress of Langerhans cell histiocytosis［J］.Chinese Journal of Experimental Hematology,2020,28(01):354-358.
［17］CHOW TW,LEUNG WK,CHENG FWT,et al.Late outcomes in children with Langerhans cell histiocytosis［J］.Archives of Disease in Childhood,2017,102(9):830-835.
［18］SU M,GAO YJ,PAN C,et al.Outcome of children with Langerhans cell histiocytosis and single-system involvement:A retrospective study at a single center in Shanghai,China［J］.Pediatric Hematology and Oncology,2018,35(7-8):385-392.
［19］ZHOU ZZ,ZHANG HQ,GUO CF,et al.Management of eosinophilic granuloma in pediatric patients:Surgical intervention and surgery combined with postoperative radiotherapy and/or chemotherapy［J］.Child's Nervous System,2017,33(4):583-593.
［20］RANEY RB,DANGIO GJ.Langerhans' cell histiocytosis(histiocytosis X):Experience at the children's hospital of philadelphia,1970-1984［J］.Med Pediatr Oncol,1989,17(1):20-28.

Memo

Memo:
-
Last Update: 1900-01-01