Valerie Broadbent

Learn More
OBJECTIVE To compare 2 active agents, vinblastine and etoposide, in the treatment of multisystem Langerhans' cell histiocytosis (LCH) in an international randomized study. STUDY DESIGN One hundred forty-three untreated patients were randomly assigned to receive 24 weeks of vinblastine (6 mg/m(2), given intravenously every week) or etoposide (150(More)
Langerhans cell histiocytosis (LCH) has presented problems in diagnosis and in treatment. The definitive diagnosis is a pathologic one. To advance thorough and uniform assessment of these patients, the elements of a complete clinical and laboratory evaluation are presented by the Histiocyte Society. Adoption of a uniform clinical/laboratory approach to(More)
Langerhans cell histiocytosis is a disease which frustrates both clinician and scientist. Its aetiology is unknown, its pathogenesis is ill understood and the clinical course is unpredictable. Historically, the different nomenclatures reflecting the first clinical descriptions by Hand (1893, 1921), Schuller (1915) and Christian (1920), and subsequently by(More)
An international randomized trial in Langerhans cell histiocytosis (LCH) has been initiated by the Histiocyte Society. This report reviews the rationale, design, and progress of LCH-I, which compares etoposide (VP-16) and vinblastine in the treatment of disseminated LCH. Data on the risk of etoposide-associated (therapy-induced) malignancy, in the setting(More)
In this paper we describe a 9-year-old girl with abdominal embryonal rhabdomyosarcoma. She had ascites and widespread metastatic disease at presentation and was oliguric but had a normal creatinine. Following the start of chemotherapy she developed acute renal failure secondary to the tumor lysis syndrome, requiring hemodialysis, and had considerable(More)
Multisystem Langerhans cell histiocytosis (MS-LCH) is associated with high mortality when patients have risk organ involvement (RO(+)) or are younger than 2 years. In an international randomized trial, LCH-II, we intensified their treatment: arm A consisted of 6 weeks of daily prednisone and weekly vinblastine followed by 18 weeks of daily 6-mercaptopurine(More)
In Langerhans' cell histiocytosis, the prognostic significance of pulmonary disease is controversial. The clinical and radiological features and lung function tests of Langerhans' cell histiocytosis patients presenting to a single tertiary referral center between 1981 and 1987 were reviewed. Age at diagnosis ranged from 2 weeks to 16 years (median 1.7(More)
Two infants presented with biopsy-proven histiocytosis X affecting multiple sites. Since neither showed evidence of organ failure or of constitutional upset, no specific therapy was given. In each case there was long-lasting spontaneous regression of disease. Analysis of blood mononuclear cells revealed a raised T4:T8 (helper:suppressor T lymphocyte) ratio(More)
The changing concept of the pathogenesis of Langerhans cell histiocytosis over the past 50 years has been mirrored by evolving treatment regimens. The publications by the Histiocyte Society in the 1980s of diagnostic, clinical, and laboratory criteria allowed international collaboration in treatment trials. These, in turn, have allowed stratification of(More)
Diabetes insipidus is a well-recognized complication of Langerhans-cell histiocytosis (histiocytosis X), but its frequency and natural history are not well defined. Of 52 children with histiocytosis whom we studied, 12 (23 percent) had diabetes insipidus. Only two children had diabetes insipidus at presentation with histiocytosis, but the cumulative risk(More)