Therapeutic efficacy of interferon alfa-2b in infants with life-threatening giant hemangiomas
L. Tamayo, D. M. Ortiz, L. Orozco-Covarrubias, C. Duran-McKinster, M. A. Mora, E. Avila, F. Teixeira and R. Ruiz-Maldonado
Department of Dermatology, National Institute of Pediatrics, Mexico City, Mexico.
BACKGROUND: Because of their size and the possibility of complications,
giant hemangiomas represent a therapeutic challenge. Various forms of
treatment have been used, with variable results, including surgery,
embolization, lasers, pentoxifylline, and corticosteroids. Interferon alfa
has been used successfully to treat life-threatening hemangiomas, possibly
by means of its antiangiogenic activity. OBSERVATIONS: We treated 7 infants
with organ-interfering and/or life-threatening giant hemangiomas with
subcutaneous injections of 3 million U/m2 per day of interferon alfa-2b
during the first month and subsequently every 48 to 72 hours, depending on
the evolution in each case. The treatment lasted from 3 to 12 months. In 2
patients, interferon alfa-2b was administered while prednisone therapy was
being tapered. In all 7 patients, there was considerable reduction of the
volume of the hemangiomas and remission of their complications. All
patients presented with fever, neutropenia, and an increase in serum
aminotransferase levels. The patients who received interferon alfa-2b and
prednisone seemed to improve at a faster rate. CONCLUSIONS: Interferon
alfa-2b is a good option for the treatment of patients with
steroid-resistant, organ-interfering and/or life-threatening giant
hemangiomas. In our experience, the adverse effects were transient and
minor and did not require the interruption of the treatment.
