Peer-review started: March 19, 2019
First decision: September 17, 2019
Revised: October 26, 2019
Accepted: December 6, 2019
Article in press: December 6, 2019
Published online: December 20, 2019
Processing time: 280 Days and 14.2 Hours
Langerhans cell histiocytosis (LCH) is a rare neoplastic disease in dendritic cells. LCH is classified as either a single-system (SS) or multisystem (MS) disease. There is not a standard first-line treatment for LCH in adults. We analyzed the efficacy and safety of immunomodulatory drugs (IMiDs) by searching PubMed/MEDLINE for case reports previously published. The clinical response (nonactive disease or active disease that regressed) was 94% in SS and 53% in MS. IMiDs should only be considered for adults with cutaneous SS involvement; in MS, they should be used only for patients not eligible for more aggressive treatments.
Core tip: Langerhans cell histiocytosis (LCH) is a rare neoplastic disease derived from dendritic cells that is seen in children as well as in adults. There is not a standard first-line treatment in adults; no prospective trials have been undertaken on this population, and chemotherapy schedules are often reported from pediatric experiences with suboptimal efficacy and a higher toxicity in adults than in children. Immunomodulatory drugs (IMiDs), as less toxic therapeutic options, have been considered for treating LCH. We analyzed the efficacy and safety of IMiDs in adults with LCH from previously published research.