Vincristine treatment for function- and life-threatening infantile hemangioma

• Published in: Archives de pédiatrie : organe officiel de la Société française de pédiatrie 2004-02, Vol.11 (2), p.99-107
• Main Authors: Enjolras, O, Brevière, G M, Roger, G, Tovi, M, Pellegrino, B, Varotti, E, Soupre, V, Picard, A, Leverger, G
• Format: Article
• Language: fre
• Subjects: Antineoplastic Agents, Phytogenic - therapeutic use; Female; Hemangioma - drug therapy; Humans; Infant; Infant, Newborn; Male; Retrospective Studies; Severity of Illness Index; Skin Neoplasms - drug therapy; Vincristine - therapeutic use
• ISSN: 0929-693X
• DOI: 10.1016/j.arcped.2003.10.014

To evaluate the efficacy of vincristine treatment for function- and life-threatening hemangiomas. Nine infants, eight girls and one boy, received vincristine treatment (VCR) for endangering hemangiomas. In six cases, the hemangiomas involved head and neck in a segmental unilateral or bilateral distribution (3/6 also had laryngeal and 2/6 tracheal location causing respiratory distress, 5/6 had eyelid and orbital involvement); one infant had disseminated neonatal hemangiomatosis (skin, liver, kidney); two infants had liver hemangiomas with cardiac failure. VCR was prescribed after failure of high-dosage corticosteroid treatment in six, and of both corticosteroids and interferon alpha 2b (5 months) in one; two infants received VCR as first line treatment. A dosage of 1 mg/m(2) IV injection was delivered, with weekly injections first, and then tapering, increasing the interval between injections, depending on the clinical response. The nine infants received from 5 to 25 injections (average: 16), for a length of treatment of 1.5-8 months (average: 5.5 months). In seven patients a clear clinical response was observed at the end of the first month of treatment, while a slow protracted response was noted in two. Transient mild side effects were present in four patients. Corticosteroid treatment, although a worldwide recognized treatment of problematic hemangiomas, cannot always control the growth of alarming hemangiomas. Interferon alpha 2a and 2b have proven a 90% effectiveness: treatment for cortico-resistant, function- and life-threatening, hemangiomas.