title: Patients with lymphatic malformations who receive the immunostimulant OK-432 experience excellent long-term outcomes.
abstract: OBJECTIVE
  Sclerotherapy is the primary treatment for lymphatic malformations. The aim of this study was to evaluate the long-term outcome in patients with lymphatic malformations treated with the immunostimulant OK-432 as a sclerosant.
  
  
  METHODS
  Between 1998 and 2013, we enrolled 131 of 138 eligible patients treated with OK-432 for lymphatic malformations in a retrospective study. The malformations were categorised according to the International Society for the Study of Vascular Anomalies. The outcome was assessed with a clinical examination and a questionnaire.
  
  
  RESULTS
  The lymphatic malformations were localised to the head/neck (60%), the trunk (20%) and the extremities (6%) or involved with more than one region (14%). Patients with microcystic (10%), macrocystic (21%) and mixed lymphatic malformations (69%) underwent a median number of three, two and two injection treatments, respectively. The median age at the first injection was 3.4 years. Good or excellent clinical outcomes were seen in 70% of the patients. The number of injections, previous treatment and lesion localisation, but not time to follow-up and cyst size, predicted the clinical outcome.
  
  
  CONCLUSIONS
  OK-432 treatment resulted in a successful outcome in 70% of patients with lymphatic malformations. The long-term outcome was comparable to the short-term outcome.
authors.affiliation: Department of Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden.|Unit of Pediatric Surgery, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: N
authors.initials: N
authors.lastname: Ghaffarpour
authors.affiliation: Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Petrini
authors.affiliation: Department of Medical Physics, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: L A
authors.initials: LA
authors.lastname: Svensson
authors.affiliation: Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Boman
authors.affiliation: Department of Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden.|Unit of Pediatric Surgery, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Wester
authors.affiliation: Department of Pediatric Surgery, Karolinska University Hospital, Stockholm, Sweden.|Unit of Pediatric Surgery, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Claesson
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D044148:Lymphatic Abnormalities / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010844:Picibanil / Q000627:therapeutic use*; D012074:Remission Induction; D012189:Retrospective Studies; D015911:Sclerotherapy; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000276:Adjuvants, Immunologic; D010844:Picibanil
keywords: Lymphatic malformation; OK-432; Sclerotherapy; Surgery