title: [Comprehensive therapy for infant vascular tumor associated with Kasabach-Merritt phenomenon].
abstract: OBJECTIVE
  To summarize the management of infant vascular tumors with Kasabach-Merritt phenomenon (KMP) and to evaluate the effect of drug combined with sclerotherapy.
  
  
  METHODS
  From Feb. 2007 to Nov. 2014, 25 cases with KMP, who underwent drug therapy combined with sclerotherapy, were retrospectively studied. Oral corticosteroids (2 mg/kg per day) was used as the first-line therapy on all of the patients and intravenous vincristine (1.5 mg/m2 every week) was added when the platelet counts didn't recover obviously after 2-3 weeks. After the recovery of the platelet counts, the patients were admitted for sclerotherapy (average, 4.56 sessions per case) with 100% alcohol (1-3 ml per session), Lauromacrogol (1.25-5 ml per session) and betamethasone (0.25-1 ml per session). All the patients were followed up for 42 months ( range, 9 months to 6.5 years). Therapeutic outcomes were assessed by evaluating platelet counts, size of lesion, function of trunk and limb.
  
  
  RESULTS
  All the 25 cases got obvious recovery in the platelet counts [average, (94.3 ± 18.5) x 10(9)/L] after drug therapy, of which 16 were treated by single oral corticosteroids for 4-7 weeks and 9 were treated by corticosteroids plus intravenous vincristine for 2-5 weeks. Meantime, 11 cases received platelet transfusions, of which 3 were coupled with gamma globulin intramuscularly. During the first admission, each of the 25 cases received 1-4 sessions of sclerotherapy (average, 2.6 sessions each case). One week after the sclerotherapy, the platelet counts returned to (167-312) x 10(9)/L (average, (258.5 ± 34.4) x 10(9)/L). The hemoglobin and blood coagulation function returned to normal within 1-5 weeks. Meanwhile the mental condition, appetite, body weight, sleeping were greatly improved. The size of the lesions decreased gradually after the combined therapy including 13 cases within 3-12 months and 13 cases within 13-36 months. Long term follow-up indicated that only 1 case need treatment for recurrent decrease of platelet counts, and all of the 25 cases kept the normal weight, height, immunity as well as the growing development.
  
  
  CONCLUSIONS
  Oral corticosteroids plus intravenous vincristine combined with sclerotherapy is a reliable management with high cure rate, short course and minor side-effect.
authors.forename: Xu
authors.initials: X
authors.lastname: Miao
authors.forename: OuYang
authors.initials: O
authors.lastname: Tianxiang
authors.forename: Xiao
authors.initials: X
authors.lastname: Yan
authors.forename: Huang
authors.initials: H
authors.lastname: Yingying
authors.forename: Chen
authors.initials: C
authors.lastname: Huiping
authors.forename: Yu
authors.initials: Y
authors.lastname: Jie
authors.forename: Ma
authors.initials: M
authors.lastname: Xiaorong
authors.forename: Zhao
authors.initials: Z
authors.lastname: Tinghui
authors.forename: Chang
authors.initials: C
authors.lastname: Mengling
authors.forename: Lin
authors.initials: L
authors.lastname: Jun
authors.forename: Liu
authors.initials: L
authors.lastname: Jun
mesh_terms: D000284:Administration, Oral; D001623:Betamethasone / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000379:methods; D000431:Ethanol / Q000008:administration & dosage; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D059885:Kasabach-Merritt Syndrome / Q000097:blood / Q000628:therapy*; D010976:Platelet Count; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage; D012189:Retrospective Studies; D015911:Sclerotherapy / Q000379:methods*; D014750:Vincristine / Q000008:administration & dosage*
chemical_list: D005938:Glucocorticoids; D000077423:Polidocanol; D000431:Ethanol; D011092:Polyethylene Glycols; D014750:Vincristine; D001623:Betamethasone