Azoulay, Lévi-Dan

Lin et al. report the long‐term follow‐up of a phase II trial involving 95 adult patients with Langerhans cell histiocytosis (LCH), investigating the combination of methotrexate and cytarabine (MA). After a median follow‐up of 6.5 years, the study showed high response rates, with 90% overall response; 55% of patients free from an event such as disease progression, poor response or death; and 93% of patients were alive, though nearly half experienced febrile neutropenia. This prospective study helps fill gaps in understanding adult LCH treatment, indicating that fixed‐duration chemotherapy can yield durable responses despite its associated risks. It emphasizes the importance of personalized treatment decisions, considering both fixed‐duration chemotherapy and continuous targeted agents based on patient and disease‐specific factors.Commentary on: Lin et al. Long term follow‐up of methotrexate and cytarabine in adult patients with Langerhans cell histiocytosis. Br J Haematol 2025; 206:576‐584.