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Treatment of haemangiomas using propranolol in paediatric patients: a retrospective cohort study
Przemysław Gałązka1, Weronika Bereźnicka1, Kamil Leis1
1Department of General and Oncological Surgery for Children and Adolescents, Antoni Jurasz University Hospital No. 1 in Bydgoszcz, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
Insights
Propranolol effectively treats infantile haemangiomas (IHs) in over 95% of cases, with manageable side effects. Delayed dose escalation did not impact treatment effectiveness.
Area of Science:
- Pediatric Oncology
- Dermatology
- Pharmacology
Background:
- Infantile haemangiomas (IHs) are common benign vascular tumors in early childhood.
- IHs can cause cosmetic concerns and potential health complications.
Purpose of the Study:
- To present the treatment method and outcomes for IHs using propranolol.
- To evaluate propranolol's efficacy and safety at a maximum dose of 3 mg/kg/day.
Main Methods:
- A cohort of 108 infants (2-21 months) with IHs were treated between 2013-2018.
- Ultrasound (USG) assessed lesion size and progression; coagulation parameters were monitored.
- Treatment involved a gradual increase to a maximum propranolol dose of 3 mg/kg/day over 3-5 months.
Main Results:
- Over 95% of patients (103/108) showed lesion reduction.
- Coagulation abnormalities decreased significantly post-treatment (19 vs. 82 patients).
- Treatment duration exceeded 12 months; common side effects included anxiety and nightmares, none life-threatening.
Conclusions:
- Delayed propranolol dose escalation to the maximum therapeutic level did not compromise treatment effectiveness for IHs.
- The observed side effects were generally mild and not detrimental to patient health.
- This approach offers a safe and effective treatment strategy for infantile haemangiomas.
Introduction:
Haemangioma, one of the most common benign neoplasms of early childhood, is a significant clinical problem due to cosmetic reasons but also because of possible health complications.
Aim:
Presentation of the method and results of treatment of infantile haemangiomas (IHs) using propranolol in a maximum dose of 3 mg/kg/day.
Material And Methods:
In 2013 to 2018 there were 108 patients with IHs multidisciplinary diagnosed and treated. 77 of them were girls and 31 were boys; all were between the ages of 2 and 21 months (mean: 6.87 months). Lesions were most often located in the head region (n = 73). The main imaging study assessing the arteriovenous flow was USG, which was used to assess the size of haemangioma and its regression or progression. Also, coagulation parameters were analysed using laboratory tests.
Results:
Reduction of lesions occurred in 103 of 108 patients, which results in a percentage score above 95. In 19 patients, after completion of treatment, there were abnormalities of coagulation in laboratory tests whereas before the treatment, these abnormalities occurred in 82 patients. The average duration of treatment was longer than 12 months and the maximum dose of propranolol of 3 mg/kg/day was achieved after 3 to 5 months of treatment. Side effects occurred totally in 19 patients, with night anxiety and nightmares being the most common.
Conclusions:
After achieving the maximum dose of the drug later than recommended in the Recommendation of the Polish Haemangioma and Vascular Malformations Group criteria, there was no need for longer therapy, while the effectiveness of the treatment remained unchanged. Side effects that occurred were not life-threatening or detrimental to the health of patients.
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