title: OK432 versus doxycycline for treatment of macrocystic lymphatic malformations.
abstract: OBJECTIVE
  A variety of sclerotherapy agents are used to treat macrocystic lymphatic malformations (LMs). This retrospective study at a single institution was performed to compare the outcomes of pediatric macrocystic LMs of the head and neck that were treated with doxycycline or with OK432.
  
  
  METHODS
  The outcomes measured included early response to therapy, number of treatments required, operating room time, and adverse events.
  
  
  RESULTS
  The rates of clinical success for OK432 and doxycycline were similar (83% and 82%, respectively; p > 0.05), although OK432-treated patients required more treatments than did doxycycline-treated patients (1.9 versus 1.0 injections; p = 0.01; 95% confidence interval, 1.57 to 0.27). The average operating room time for a single OK432 injection was significantly shorter than that for doxycycline (53.2 versus 98.1 minutes; p < 0.001); however, when the total number of treatments administered was considered, the overall times in the operating room were similar. Adverse events in the early postoperative period were more common in OK432-treated patients, who experienced marked postoperative swelling compared to doxycycline-treated patients.
  
  
  CONCLUSIONS
  OK432 and doxycycline are both effective sclerosants for the treatment of predominantly macrocystic LMs. The administration time for OK432 is shorter than that for doxycycline, but OK432 required more treatments overall to achieve clinical success. Early adverse events were more common in OK432-treated patients, but longer follow-up is necessary to determine whether rates of recurrence and adverse events are similar, particularly in light of the risk of tooth discoloration in doxycycline-treated patients.
authors.affiliation: Georgetown University School of Medicine (Motz, Nickley), Children's National Medical Center, George Washington University School of Medicine, Washington, DC.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Motz
authors.forename: Katherine B
authors.initials: KB
authors.lastname: Nickley
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Bedwell
authors.forename: Bhupender
authors.initials: B
authors.lastname: Yadav
authors.forename: Philip C
authors.initials: PC
authors.lastname: Guzzetta
authors.forename: Albert K
authors.initials: AK
authors.lastname: Oh
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Bauman
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004318:Doxycycline / Q000008:administration & dosage*; D005260:Female; D006257:Head; D006801:Humans; D007223:Infant; D044148:Lymphatic Abnormalities / Q000473:pathology / Q000628:therapy*; D008297:Male; D009333:Neck; D010844:Picibanil / Q000008:administration & dosage*; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage; D015911:Sclerotherapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D012597:Sclerosing Solutions; D010844:Picibanil; D004318:Doxycycline
keywords: OK432; doxycycline; lymphatic malformation; sclerotherapy