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Clinical observations in mesh suture treatment for infants of Kasabach-Merritt phenomenon
Kelei Li1, Maozhong Tai1, Zhongping Qin1
1Department of Hemangioma Characteristic, LinYi Tumor Hospital, Linyi, China.
Insights
Mesh suture treatment effectively resolves Kasabach-Merritt phenomenon in infants. This approach normalizes platelet counts and reduces tumor size, offering a promising first-line therapy for this rare condition.
Area of Science:
- Pediatric Oncology
- Vascular Anomalies
- Surgical Interventions
Background:
- Kasabach-Merritt phenomenon (KMP) is a rare condition characterized by a vascular tumor associated with severe coagulopathy.
- Infants with KMP often present with life-threatening thrombocytopenia, hypofibrinogenemia, and elevated D-dimer levels.
Purpose of the Study:
- To evaluate the efficacy and safety of mesh suture treatment for KMP in infants.
- To report treatment experience and outcomes in a small cohort of KMP patients.
Main Methods:
- Mesh suture treatment applied to the tumor area in three infants with KMP.
- Pre- and post-treatment assessments included platelet counts, fibrinogen, D-dimer levels, and tumor characteristics (color, texture, swelling).
- Follow-up ranged from 6 months to 1 year.
Main Results:
- Successful tumor regression observed, with reduced swelling and normalization of color and texture.
- Rapid increase in platelet counts post-treatment, reaching normal levels within a week in most cases.
- Significant improvement in coagulation parameters: increased fibrinogen and decreased D-dimer levels. Complete lesion regression and no relapse during follow-up.
Conclusions:
- Mesh suture treatment is a highly effective and recommended first-line therapy for pediatric Kasabach-Merritt phenomenon.
- The procedure leads to rapid hematologic and clinical improvement with minimal complications.
- This technique offers a safe and successful management strategy for KMP.
Aim:
This study aims to evaluate the efficacy and adverse effects of the mesh suture treatment for infants of Kasabach-Merritt phenomenon and to report our treatment experience.
Methods:
Of the three patients, two of the cases occurred in the scalp and one occurred in the back of the chest, with platelet counts < 40 × 109 /L before the treatment, reduced fibrinogen levels and increased D-dimer levels. All the three patients underwent the mesh suture treatment of the tumour area. Post-treatment observations were made regarding the surface colour and texture of the tumours, periodic routine blood examination results, fibrinogen and D-dimer levels.
Results:
After treatment, the degree of swelling on the tumour surface was reduced, surface tension was decreased, the tumour colour turned pale red from dark red and the skin gradually returned to normal. Two days after treatment, the platelet counts increased to 70 × 109 /L or higher; the platelet count reached a normal level after 1 week in two cases. The fibrinogen level increased in varying degrees after treatment, whereas the D-dimer level was reduced. One case showed a small amount of exudate at the suture area, 1 month after the treatment; improvements were observed 3 days after changing the local dressing. All the patients were followed up for 6 months to 1 year, during which the patients showed complete regression of the lesion and relapse, normal platelet counts and normal fibrinogen and D-dimer levels.
Conclusions:
We recommend the mesh suture treatment as the first treatment of choice for paediatric Kasabach-Merritt phenomenon.
