Treatment of massive or life-threatening hemangiomas with recombinant α(2a)-interferon
Otolaryngology - Head and Neck Surgery
OBJECTIVE: To assess the response of massive, life-threatening, or function-impairing hemanglomas in pediatric patients receiving daily α(2a)- interferon subcutaneously. METHODS: The effect of 3 or more months of subcutaneous α(2a)-interferon (3 mU/m2) was prospectively evaluated in 10 patients with hemangiomas necessitating medical intervention. Hemangloma characteristics and extent were initially assessed by radiographic imaging in all but one patient. α(2a)-interferon tolerance was monitored, and reduction in hemangioma size was recorded as marked (>50%), moderate (25% to 50%), or minimal (<25%). RESULTS: Hemangiomas were apparent at birth in 8 of 10 patients, and α(2a) -interferon was initiated at a median age of 4.5 months. Symptoms necessitating therapeutic intervention included congestive heart failure, airway obstruction, dysphagia, infection, failure to thrive, external auditory canal occlusion, visual axis impairment, and severe facial deformity. Four patients received treatment before referral that included systemic steroids (n = 2), intralesional steroids (n = 1), or surgical/laser excision (n = 2). α(2a)-interferon therapy was well tolerated. Mast patients had a temporary elevation in body temperature during the first month of therapy. One patient with anoxia required nasogastric feedings and a temporary reduction in her α(2a)-interferon dose. An additional patient with irritability was withdrawn from the study at his parents' request even though this symptom porsisted after drug cessation. Hemangioma response to α(2a)-interferon was marked in six patients, moderate in two, and minimal in one whose lesion had features suggestive of a vascular malformation. Early signs of involution were usually evident within 6 weeks and often heralded by cutaneous blanchlng. α(2a)-interferon therapy was concluded in four patients after a mean duration of 20 months. CONCLUSIONS: Dally subcutaneous α(2a)-interferon is well tolerated in pediatric patients and appears effective in hastening involution of symptomatic hemangiomas. A significant response is unlikely in lesions with features suggestive of a vascular malformation.
Bauman, N., Burke, D., & Smith, R. (1997). Treatment of massive or life-threatening hemangiomas with recombinant α(2a)-interferon. Otolaryngology - Head and Neck Surgery, 117 (1). http://dx.doi.org/10.1016/S0194-5998(97)70215-8