Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019621 (Langerhans cell histiocytosis)
 3,250 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The successful use of cytotoxic agents in the clinical management of LCH depends upon the selective targeting of cells participating in the disease process. The topoisomerase 'poisons', currently used extensively in the treatment of aggressive malignancies, represent an intriguing class of cytotoxic agents exerting their cytostatic and cytotoxic effects at multiple levels according to cell type. The non-DNA intercalating topoisomerase II poison, etoposide (VP-16), is the "drug of first choice" in the treatment of LCH by cytotoxic chemotherapy. This major anticancer agent traps the nuclear enzyme DNA topoisomerase II on DNA in a sequence-specific manner, the processing of trapped complexes giving rise to a plethora of cellular effects not least the potential activation of pathways leading to cell cycle arrest and apoptosis. This short review describes the principles of topoisomerase inhibition, the multiplicity of cellular effects and the concept of cellular targeting in LCH. The successful treatment of LCH by cytotoxic chemotherapy will depend on both the identity of the target tissues and a clear view of therapeutic intent, given the potential for induction of haematological neoplasia.
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PMID:Multilevel therapeutic targeting by topoisomerase inhibitors. 807 6

Of the several kinds of therapy-related leukemia, therapy-related acute promyelocytic leukemia (t-APL) is most closely associated with topoisomerase II inhibitor administration for treatment of malignancies in adults. Although rare in children, the majority of therapy-related malignancies have been etoposide-related APL associated with Langerhans cell histiocytosis. The authors describe the development of t-APL after chemotherapy administered for non-Hodgkin's lymphoma (NHL) in an 8-year-old girl. One month after cessation of the 3-year chemotherapy regimen of doxorubicin and other agents but not etoposide or radiotherapy, the patient was diagnosed with t-APL with positive PML-RARA molecular abnormality. The patient attained a complete remission following treatment with all-trans retinoic acid-containing chemotherapy. Thereafter, she successfully received hematopoietic stem cell transplantation from an HLA-matched sibling donor. Development of t-APL associated with NHL in children appears to be rare.
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PMID:Secondary acute promyelocytic leukemia following chemotherapy for non-Hodgkin's lymphoma in a child. 1521 16