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Recurrent Skin Langerhan Cell Histiocytosis Successfully Treated With Indomethacin Monotherapy

Dhir, Aditi MD*; Kelly, David R. MD; Watts, Raymond G. MD; Kutny, Matthew A. MD*

Journal of Pediatric Hematology/Oncology: April 03, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPH.0000000000001474
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Langerhans cell histiocytosis (LCH) often has a recurrent and refractory course despite multiagent treatment modalities. Common relapse treatments include intense or prolonged cytotoxic chemotherapy regimens. There are a few prior reports that the nonsteroidal anti-inflammatory drug indomethacin demonstrated activity against bone LCH. Here we report indomethacin as a successful treatment for a case of chronic skin LCH that failed multiple prior chemotherapy regimens. This experience supports the need for trials to investigate indomethacin as a treatment for LCH both in the relapsed or refractory setting as well as potential combination or maintenance therapy in newly diagnosed patients.

*Department of Pediatrics, Division of Hematology/Oncology, University of Alabama at Birmingham

Department of Pathology, Children’s of Alabama, Birmingham, AL

Department of Pediatrics, Louisiana State University (LSU) Health New Orleans, New Orleans, LA

A.D. and M.A.K. contributed to the initial draft of the case description and discussion.

The authors declare no conflict of interest.

Reprints: Matthew A. Kutny, MD, Department of Pediatrics, Division of Hematology Oncology, University of Alabama at Birmingham, 1600 7th Avenue South, Birmingham, AL 35233 (e-mail: mkutny@peds.uab.edu).

Received December 27, 2018

Accepted February 15, 2019

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