[Vincristine treatment for function- and life-threatening infantile hemangioma].
OBJECTIVE
To evaluate the efficacy of vincristine treatment for function- and life-threatening hemangiomas.


METHODS
Nine infants, eight girls and one boy, received vincristine treatment (VCR) for endangering hemangiomas. In six cases, the hemangiomas involved head and neck in a segmental unilateral or bilateral distribution (3/6 also had laryngeal and 2/6 tracheal location causing respiratory distress, 5/6 had eyelid and orbital involvement); one infant had disseminated neonatal hemangiomatosis (skin, liver, kidney); two infants had liver hemangiomas with cardiac failure. VCR was prescribed after failure of high-dosage corticosteroid treatment in six, and of both corticosteroids and interferon alpha 2b (5 months) in one; two infants received VCR as first line treatment.


RESULTS
A dosage of 1 mg/m(2) IV injection was delivered, with weekly injections first, and then tapering, increasing the interval between injections, depending on the clinical response. The nine infants received from 5 to 25 injections (average: 16), for a length of treatment of 1.5-8 months (average: 5.5 months). In seven patients a clear clinical response was observed at the end of the first month of treatment, while a slow protracted response was noted in two. Transient mild side effects were present in four patients.


CONCLUSIONS
Corticosteroid treatment, although a worldwide recognized treatment of problematic hemangiomas, cannot always control the growth of alarming hemangiomas. Interferon alpha 2a and 2b have proven a 90% effectiveness: treatment for cortico-resistant, function- and life-threatening, hemangiomas.
Enjolras
O
O
Consultation des angiomes, hôpital Lariboisière, AP-HP, 75010 Paris, France. odile.enjolras@lrb.ap-hop-paris.fr
Brevière
G M
GM
Roger
G
G
Tovi
M
M
Pellegrino
B
B
Varotti
E
E
Soupre
V
V
Picard
A
A
Leverger
G
G
D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D005260:Female; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012878:Skin Neoplasms / Q000188:drug therapy*; D014750:Vincristine / Q000627:therapeutic use*
D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine