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dc.contributor.authorAlston, Robert D
dc.contributor.authorTatevossian, R G
dc.contributor.authorMcNally, Richard J Q
dc.contributor.authorKelsey, Anna M
dc.contributor.authorBirch, Jillian M
dc.contributor.authorEden, Tim O B
dc.date.accessioned2009-06-11T11:03:40Z
dc.date.available2009-06-11T11:03:40Z
dc.date.issued2007-05
dc.identifier.citationIncidence and survival of childhood Langerhans cell histiocytosis in Northwest England from 1954 to 1998. 2007, 48 (5):555-60 Pediatr Blood Canceren
dc.identifier.issn1545-5009
dc.identifier.pmid16652350
dc.identifier.doi10.1002/pbc.20884
dc.identifier.urihttp://hdl.handle.net/10541/70156
dc.description.abstractBACKGROUND: Langerhans cell histiocytosis (LCH) is a rare proliferative disorder of pathological Langerhans cells, for which the aetiology and pathogenesis remain largely unknown. PROCEDURE: Information on the 101 children with LCH registered with the population-based Manchester Children's Tumour Registry (MCTR) between 1954 and 1998 was extracted from the records of the MCTR. This included age, sex, date of diagnosis, systems affected at diagnosis and follow-up. RESULTS: The overall incidence rate for LCH was 2.6 cases per million child years. In those under 1 year of age the incidence rate was 9.0 cases per million child years, compared to 0.7 cases per million in those aged 10-14 years (P < 0.0001 for age trend). There was no evidence of seasonal variation in presentation by month of birth or first symptom. Bone was the most common site of disease involvement (67% of cases), followed by skin (37%) and soft tissue (22%). The overall survival rate has improved over time, from 57% in 1954-1968 to 74% in 1985-1998. Ninety percent of deaths were due to disease progression, the remainder were due to complications of intensive therapy. The site of LCH lesions and extent of disease present at diagnosis strongly predicted survival outcome. Patients with initial liver involvement had a 5-year survival rate of 25% compared with 93% for those with bone lesions alone at diagnosis. CONCLUSIONS: Incidence rates varied significantly by age at diagnosis, and have been stable over time. Survival has improved considerably over time, but varies strongly by age and systems affected at diagnosis.
dc.language.isoenen
dc.subject.meshAdolescent
dc.subject.meshAge Factors
dc.subject.meshBone and Bones
dc.subject.meshChild
dc.subject.meshChild, Preschool
dc.subject.meshDisease Progression
dc.subject.meshEngland
dc.subject.meshFemale
dc.subject.meshHistiocytosis, Langerhans-Cell
dc.subject.meshHumans
dc.subject.meshInfant
dc.subject.meshLiver
dc.subject.meshMale
dc.subject.meshSeasons
dc.subject.meshSkin
dc.subject.meshSurvival Rate
dc.titleIncidence and survival of childhood Langerhans cell histiocytosis in Northwest England from 1954 to 1998.en
dc.typeArticleen
dc.contributor.departmentCancer Research UK Paediatric and Familial Cancer Research Group, Central Manchester and Manchester Children's University Hospitals NHS Trust, Manchester, United Kingdom.en
dc.identifier.journalPediatric Blood & Canceren
html.description.abstractBACKGROUND: Langerhans cell histiocytosis (LCH) is a rare proliferative disorder of pathological Langerhans cells, for which the aetiology and pathogenesis remain largely unknown. PROCEDURE: Information on the 101 children with LCH registered with the population-based Manchester Children's Tumour Registry (MCTR) between 1954 and 1998 was extracted from the records of the MCTR. This included age, sex, date of diagnosis, systems affected at diagnosis and follow-up. RESULTS: The overall incidence rate for LCH was 2.6 cases per million child years. In those under 1 year of age the incidence rate was 9.0 cases per million child years, compared to 0.7 cases per million in those aged 10-14 years (P < 0.0001 for age trend). There was no evidence of seasonal variation in presentation by month of birth or first symptom. Bone was the most common site of disease involvement (67% of cases), followed by skin (37%) and soft tissue (22%). The overall survival rate has improved over time, from 57% in 1954-1968 to 74% in 1985-1998. Ninety percent of deaths were due to disease progression, the remainder were due to complications of intensive therapy. The site of LCH lesions and extent of disease present at diagnosis strongly predicted survival outcome. Patients with initial liver involvement had a 5-year survival rate of 25% compared with 93% for those with bone lesions alone at diagnosis. CONCLUSIONS: Incidence rates varied significantly by age at diagnosis, and have been stable over time. Survival has improved considerably over time, but varies strongly by age and systems affected at diagnosis.


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