title: Treatment of Corticosteroid-Resistant Vascular Tumors Associated with the Kasabach-Merritt Phenomenon in Infants: An Approach with Transcatheter Arterial Embolization Plus Vincristine Therapy.
abstract: OBJECTIVE
  To investigate the effectiveness and application of transcatheter arterial embolization (TAE) plus systemic vincristine for treatment of corticosteroid-resistant vascular tumors associated with Kasabach-Merritt phenomenon in infants.
  
  
  METHODS
  TAE was performed in 17 infants (average age, 4.3 mo ± 2.4; range, 1-10 mo) with corticosteroid-resistant vascular tumors associated with Kasabach-Merritt phenomenon, followed by intravenous vincristine once weekly for systemic chemotherapy. The effects and complications were observed and evaluated after a cycle (1 cycle: TAE plus treatment with vincristine every 4 weeks). Cycles were repeated in infants with platelet counts < 150 × 10(9)/L.
  
  
  RESULTS
  In 17 patients, 36 treatment cycles were successfully performed. The platelet count for all patients increased to ≥ 100 × 10(9)/L for the first time at 6.0 days ± 3.5; the platelet level of 15 infants was maintained at levels > 150 × 10(9)/L at 57.5 days ± 16.5. Before treatment, two infants had a normal fibrinogen level (2.21 g/L and 2.34 g/L); the fibrinogen level in the other 15 infants was first found to be increased to ≥ 2.0 g/L at 7.0 days ± 3.4 and was stabilized at levels > 2.0 g/L at 55.9 days ± 13.8 after treatment. Complications were graded as major in four cases and as minor in 13 cases.
  
  
  CONCLUSIONS
  TAE plus vincristine can rapidly improve levels of platelets and fibrinogen, and it is an effective method for treatment of corticosteroid-resistant vascular tumors associated with Kasabach-Merritt phenomenon in infants.
authors.affiliation: Jinan University, Guangzhou, Guangdong; Department of Interventional Therapy and Vascular Anomalies Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong 510623, China.
authors.forename: Xiaoyun
authors.initials: X
authors.lastname: Tan
authors.affiliation: Department of Interventional Therapy and Vascular Anomalies Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong 510623, China.
authors.forename: Miaojuan
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Interventional Therapy and Vascular Anomalies Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong 510623, China. Electronic address: fejr@foxmail.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Interventional Therapy and Vascular Anomalies Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong 510623, China.
authors.forename: Shaoyi
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Department of Interventional Therapy and Vascular Anomalies Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong 510623, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Shen
authors.affiliation: Department of Interventional Therapy and Vascular Anomalies Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong 510623, China.
authors.forename: Zhenyin
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Interventional Therapy and Vascular Anomalies Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong 510623, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Pathology, Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong 510623, China.
authors.forename: Jiejun
authors.initials: J
authors.lastname: Xia
mesh_terms: D061605:Administration, Intravenous; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage* / Q000009:adverse effects; D001792:Blood Platelets / Q000187:drug effects; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D003907:Dexamethasone / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D019008:Drug Resistance, Neoplasm; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D007223:Infant; D059885:Kasabach-Merritt Syndrome / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D010976:Platelet Count; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000305:Adrenal Cortex Hormones; D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine; D003907:Dexamethasone; D005340:Fibrinogen