AraC for Newly Diagnosed Adult Langerhans Cell Histiocytosis

Inclusion Criteria:

• • Histologically confirmed diagnosis of LCH.
• Patients were newly diagnosed or did not receive prior systemic treatment of LCH (patients who had received radiotherapy alone were allowed).
• Age ≥18 years and ≤75 years.
• LCH involved multisystem or multifocal single system.
• Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
• Patients must have adequate renal, liver, and bone marrow function as defined bythe following criteria:
• Absolute neutrophil count ≥1500 cells per mm3 or ≥500 cells per mm3 in thecase of known hematopoietic system involvement by LCH.
• Platelet count ≥100000 cells per mm3 or ≥20000 cells per mm3 in the case ofknown hematopoietic system involvement by LCH.
• Creatinine clearance [according to Cockcroft formula] ≥60 mL/min.
• Aspartate aminotransferase and alanine aminotransferase ≤2·5×upper limit ofnormal [ULN], and total bilirubin ≤2·5×ULN; or ≤10×ULN in the case of knownliver involvement by LCH.
• No active or untreated infection.
• No cardiac abnormalities.
• Subject provide written informed consent.
• A female is eligible to enter and participate in this study if she is of:
• Non-childbearing potential including ω Any female who has had a surgicalprocedure rendering her incapable of becoming pregnant.

ω Subjects have experienced total cessation of menses for more than 1 year and be greaterthan 45 years in age.

⎫ Childbearing potential, including any female who has had a negative serum pregnancy testwithin 2 weeks prior to the first dose of study treatment, and agrees to use adequatecontraception. Male subjects must use an effective barrier method of contraception during the study andfor 90 days following the last course of MA if sexually active with a childbearingpotential

Exclusion Criteria:

• • Non-langerhans cell histiocytosis.
• Patients had concurrent malignancies.
• Patients who had received any treatment except radiotherapy for LCH.
• History of myocardial infarction, or unstable angina, or New York HeartAssociation (NYHA) Grade III-IV within 6 months prior to Day 1.
• Women who were pregnant or of childbearing potential.
• Known HIV seropositive, active hepatitis C infection, and/or hepatitis B (definedas HCV RNA ≥103 copies or HBV DNA ≥103 copies at screening).
• Major surgical procedure within 28 days prior to the first dose of studytreatment.
• Presence of uncontrolled infection.
• Evidence of active bleeding or bleeding diathesis.
• Any serious and/or unstable pre-existing medical, psychiatric, or other conditionthat could interfere with subject's safety, provision of informed consent, orcompliance to study procedures.