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Treatment of Erdheim-Chester disease with long-term high-dose interferon-α.
[erdheim-chester disease]
Erdheim-
Chester
disease
(
ECD
)
is
a
rare
non-
Langerhans
cell
histiocytosis
,
characterized
by
a
foamy
CD
68
+
,
CD
1
a-
histiocyte
tissue
infiltration
.
Efficacy
of
standard
doses
of
interferon-α-
2
a
(
IFN
α
)
has
been
suggested
in
a
small
series
but
with
variation
,
depending
on
the
organs
involved
.
Our
aim
was
to
report
our
single
-center
experience
about
the
use
of
high
-dose
IFN
α
in
ECD
.
Twenty
-
four
ECD
patients
have
received
high
-dose
IFNα
(
IFNα
≥
18
mIU
/
wk
or
pegylated-
IFNα
≥
180
μg
/
wk
)
.
IFN
α
efficacy
was
evaluated
clinically
and
morphologically
using
a
standardized
protocol
(
median
follow-up
19
months
)
.
Indication
for
treatment
was
central
nervous
system
and
/
or
heart
involvement
(
n
=
20
)
,
exophthalmos
(
n
=
1
)
,
and
standard-dose
IFNα
inefficacy
(
n
=
3
)
.
High
-dose
IFN
α
was
effective
in
16
patients
(
67
%
)
with
improvement
(
n
=
11
,
46
%
)
and
stabilization
(
n
=
5
,
21
%
)
.
Late
and
gradual
improvement
was
observed
during
prolonged
follow-up
in
most
patients
.
The
efficacy
of
high
-dose
IFN
α
was
dependent
on
the
organs
involved
:
central
nervous
system
and
heart
improvement
or
stabilization
occurred
in
7
/
11
(
64
%
)
and
11
/
14
(
79
%
)
patients
,
respectively
.
Six
patients
(
25
%
)
worsened
.
High
doses
of
IFN
α
were
well-tolerated
:
13
(
54
.
2
%
)
patients
had
side
effects
but
treatment
interruption
was
infrequent
(
n
=
3
,
12
.
5
%
)
.
High
-dose
IFN
α
may
be
effective
in
severe
ECD
.
Improvement
may
be
slow
,
and
high
-dose
IFNα
treatment
should
be
prolonged
.
Diseases
Validation
Diseases presenting
"small series"
symptom
erdheim-chester disease
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