title: Intralesional cidofovir in severe juvenile respiratory papillomatosis.
abstract: Recurrent respiratory papillomatosis causes significant morbidity among affected children and usually requires frequent surgeries. We present a prospective case series including nine children at a Mexican tertiary referral center. All enrolled patients had severe disease that had required at least four surgical procedures, with a median of 6. Two children had tracheobronchial involvement, one had lung parenchymal disease, and one had a tracheostomy performed during his first surgery.
  
  
  OBJECTIVE
  To assess the efficacy of intralesional cidofovir in lowering the surgery rate.
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  Tertiary referral center in Mexico City.
  
  
  METHODS
  Nine Mexican children with severe disease were enrolled. Intralesional cidofovir was applied after surgical debulking at a concentration of 5 mg/mL with a four to six week interval.
  
  
  RESULTS
  Six of the nine patients had a notable decrease in the rate of surgeries, with three patients remaining disease-free with follow up ranging from 1.8 to 3.3 years. No patient demonstrated laboratory abnormalities. Two patients showed moderate and mild dysplasia on papilloma biopsy distinguished by a lack of epithelial maturation with no mitoses or cellular atypia. Two patients died several months after the last injection.
  
  
  CONCLUSIONS
  Intralesional cidofovir appears to be effective in the treatment of recurrent respiratory papillomatosis, although further studies are required to determine its safety.
authors.affiliation: Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico.
authors.forename: Y
authors.initials: Y
authors.lastname: Ablanedo-Terrazas
authors.forename: A
authors.initials: A
authors.lastname: Soda-Merhy
authors.forename: M
authors.initials: M
authors.lastname: Hernández-Palestina
authors.forename: C E
authors.initials: CE
authors.lastname: Ormsby
authors.forename: G
authors.initials: G
authors.lastname: Reyes-Terán
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D000077404:Cidofovir; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D015552:Injections, Intralesional; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D009367:Neoplasm Staging; D063065:Organophosphonates / Q000008:administration & dosage*; D010212:Papilloma / Q000175:diagnosis / Q000188:drug therapy*; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir