Sandbox: Langerhans: Difference between revisions

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* Langerhans cell histiocytosis is a rare disease that tends to affect children and adolescents.<ref name="pmid25281259">{{cite journal| author=DiCaprio MR, Roberts TT| title=Diagnosis and Management of Langerhans Cell Histiocytosis. | journal=J Am Acad Orthop Surg | year= 2014 | volume= 22 | issue= 10 | pages= 643-652 | pmid=25281259 | doi=10.5435/JAAOS-22-10-643 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25281259  }} </ref><ref name="PDQ">Langerhans Cell Histiocytosis Treatment (PDQ®): Health Professional Version. National Cancer Institute (2015) http://www.cancer.gov/types/langerhans/hp/langerhans-treatment-pdq Accessed on February, 3 2016</ref><ref name="pmid25310214">{{cite journal| author=Grana N| title=Langerhans cell histiocytosis. | journal=Cancer Control | year= 2014 | volume= 21 | issue= 4 | pages= 328-34 | pmid=25310214 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25310214  }} </ref><ref name="wiki">Langerhans cell histiocytosis. Wikipedia (2015) https://en.wikipedia.org/wiki/Langerhans_cell_histiocytosis Accessed on February, 2 2016</ref><ref name="radio"> Langerhans cell histiocytosis. Radiopeadia (2015) http://radiopaedia.org/articles/langerhans-cell-histiocytosis Accessed on February, 3 2016</ref>
* The table below lists prognostic factors for Langerhans cell histiocytosis patients:
* The incidence of Langerhans cell histiocytosis is approximately 5  per 1,000,000 individuals in the United States.
{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px"
* Langerhans cell histiocytosis commonly affects individuals younger than 15 years of age.
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* The median age at diagnosis is depends on the specific subtype of the disease, such as:
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:* Pulmonary Langerhans cell histiocytosis is usually first diagnosed among adults.
! style="background: #4479BA; width: 250px; color: #FFFFFF;"|'''Prognostic Factor'''
:* Unifocal Langerhans cell histiocytosis and multifocal unisystem Langerhans cell histiocytosis are usually first diagnosed among individuals of 2-10 years of age.
 
:* Multifocal multisystem Langerhans cell histiocytosis is usually first diagnosed among individuals younger than 2 years of age.
! style="background: #4479BA; width: 600px; color: #FFFFFF;"|'''Description'''
* Males are more commonly affected with Langerhans cell histiocytosis than females. The male to female ratio is approximately 2 to 1.
 
* Langerhans cell histiocytosis usually affects Caucasian and Hispanic individuals. African American individuals are less likely to develop Langerhans cell histiocytosis.
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center | '''Age'''|| style="padding: 5px 5px; background: #F5F5F5;" |
:* Older age at the time of diagnosis is associated with a worse prognosis.
 
|-
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center | '''Gender'''|| style="padding: 5px 5px; background: #F5F5F5;"|
:* Males are associated with a worse prognosis when compared to females.
|-
 
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center | '''Performance status'''|| style="padding: 5px 5px; background: #F5F5F5;"|
:* Patient's poor [[performance status]] is associated with a worse prognosis.
|-
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center | '''Stage'''|| style="padding: 5px 5px; background: #F5F5F5;" |
:*Binet stages B and C or Rai stages 2-4 are associated with a worse prognosis.
 
|-
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center | '''Lymphocyte doubling time'''|| style="padding: 5px 5px; background: #F5F5F5;" |
:*A rapid [[lymphocyte]] doubling time is associated with a worse prognosis.
 
|-
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center | '''Genetic mutations'''|| style="padding: 5px 5px; background: #F5F5F5;"|
:*Deletion of [[chromosome 17]] short arm and [[chromosome 11]] long arm are associated with a worse prognosis.
 
|-
 
|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center | '''Prolymphocytes percent'''|| style="padding: 5px 5px; background: #F5F5F5;" |
:*An increased percentage of [[prolymphocyte]]s is associated with a worse prongnosis.
 
|-
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center | '''Histological analysis'''|| style="padding: 5px 5px; background: #F5F5F5;"|
:*Diffuse [[histology]] on [[bone marrow aspiration]] is associated with a worse prognosis.  
 
|-
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center | '''Lactate dehydrogenase (LDH) level'''|| style="padding: 5px 5px; background: #F5F5F5;"|
:*Elevated level of [[LDH]] is associated with a worse prognosis.
 
|-
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center | '''β2-microglobulin level '''|| style="padding: 5px 5px; background: #F5F5F5;"|
:*Elevated level of β2-microglobulin level is associated with a worse prognosis.
 
|-
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center | '''Lymphocyte surface markers'''|| style="padding: 5px 5px; background: #F5F5F5;"|
:*Over expression of [[CD38]] is associated with a worse prognosis.
|-
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center | '''Immunoglobulin (Ig)VH gene'''|| style="padding: 5px 5px; background: #F5F5F5;"|
:*The absence of IgVH [[gene]] mutation is associated with a worse prognosis.
 
|-
 
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align=center | '''Membrane-bound proteins'''|| style="padding: 5px 5px; background: #F5F5F5;"|
:*The expression of zeta-chain-associated protein kinase 70 (ZAP) is associated with a worse prognosis.
|}

Revision as of 16:21, 4 February 2016

  • The table below lists prognostic factors for Langerhans cell histiocytosis patients:
Prognostic Factor Description
Age
  • Older age at the time of diagnosis is associated with a worse prognosis.
Gender
  • Males are associated with a worse prognosis when compared to females.
Performance status
Stage
  • Binet stages B and C or Rai stages 2-4 are associated with a worse prognosis.
Lymphocyte doubling time
  • A rapid lymphocyte doubling time is associated with a worse prognosis.
Genetic mutations
Prolymphocytes percent
  • An increased percentage of prolymphocytes is associated with a worse prongnosis.
Histological analysis
Lactate dehydrogenase (LDH) level
  • Elevated level of LDH is associated with a worse prognosis.
β2-microglobulin level
  • Elevated level of β2-microglobulin level is associated with a worse prognosis.
Lymphocyte surface markers
  • Over expression of CD38 is associated with a worse prognosis.
Immunoglobulin (Ig)VH gene
  • The absence of IgVH gene mutation is associated with a worse prognosis.
Membrane-bound proteins
  • The expression of zeta-chain-associated protein kinase 70 (ZAP) is associated with a worse prognosis.
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