CNS involvement and treatment with interferon-α are independent prognostic factors in Erdheim-Chester disease : a multicenter survival analysis of 53 patients.
(2011) Blood — Vol. 117, n° 10, p. 2778-2782 (2011)
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- Authors
- Abstract
- Erdheim-Chester disease (ECD) is a rare form of non-Langerhans histiocytosis, with noncodified therapeutic management and high mortality. No treatment has yet been shown to improve survival in these patients. We conducted a multicenter prospective observational cohort study to assess whether extraskeletal manifestations and interferon-α treatment would influence survival in a large cohort of ECD patients. To achieve this goal, we thoroughly analyzed the clinical presentation of 53 patients with biopsy-proven ECD, and we performed a survival analysis using Cox proportional hazard model. Fifty-three patients (39 men and 14 women) with biopsy-proven ECD were followed up between November 1981 and November 2010. Forty-six patients (87%) received interferon-α and/or PEGylated interferon-α. Multivariate survival analysis using Cox proportional hazard model revealed that central nervous system involvement was an independent predictor of death (hazard ratio = 2.51; 95% confidence interval, 1.28-5.52; P = .006) in our cohort. Conversely, treatment with interferon-α was identified as an independent predictor of survival (hazard ratio = 0.32; 95% confidence interval, 0.14-0.70; P = .006). Although definitive confirmation would require a randomized controlled trial, these results suggest that interferon-α improves survival in ECD patients. This may be seen as a significant advance, as it is the first time a treatment is shown to improve survival in this multisystemic disease with high mortality.
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Citations
Arnaud, L., Hervier, B., Néel, A., Hamidou, M. A., Kahn, J.-E., Wechsler, B., Pérez-Pastor, G., Blomberg, B., Fuzibet, J.-G., Dubourguet, F., Marinho, A., Magnette, C., Noel, V., Pavic, M., Casper, J., Beucher, A.-B., Costedoat-Chalumeau, N., Aaron, L., Salvatierra, J., et al. (2011). CNS involvement and treatment with interferon-α are independent prognostic factors in Erdheim-Chester disease : a multicenter survival analysis of 53 patients. Blood, 117(10), 2778-2782. https://doi.org/10.1182/blood-2010-06-294108 (Original work published 2011)