INTERFERON ALFA-2A THERAPY FOR LIFE-THREATENING HEMANGIOMAS OF INFANCY
INTERFERON ALFA-2A THERAPY FOR LIFE-THREATENING HEMANGIOMAS OF INFANCY
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DOI：
10.1056/nejm199205283262203
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发表时间：
1992-05-28
影响因子：
158.5
通讯作者：
FOLKMAN, J
中科院分区：
文献类型：
--
作者：
EZEKOWITZ, RAB;MULLIKEN, JB;FOLKMAN, J
背景和方法。 大多数血管瘤是小的，无害的胎记，出生后不久出现，增殖8至18个月，然后在接下来的5至8年内缓慢消退，留下正常或轻微瑕疵的皮肤。在极少数情况下，血管瘤会危及重要结构，死亡率高达60%。这些危及生命的血管瘤中约有三分之一对皮质类固醇治疗有反应，但对其他人没有安全有效的治疗方法。我们评估了每日皮下注射干扰素α-2a（高达每平方米体表面积300万单位）治疗20例对皮质类固醇治疗无效的危及生命或危及视力的新生儿和婴儿血管瘤的效果。 在20名患者中，有18名患者的血管瘤在平均7.8个月的治疗后（范围，2至13个月）消退了50%或更多。一名婴儿死于难治性增生病变和消耗性凝血病。其他三名患有与消耗性凝血病相关的大血管瘤的患者的病情在单用干扰素α-2a治疗7天后稳定，这些患者对常规治疗无反应。干扰素α-2a治疗的短暂副作用包括发热、中性粒细胞减少（1例患者）和皮肤坏死（1例患者）。平均随访16个月，未见长期毒性反应。 干扰素α-2a似乎可诱导婴儿期危及生命的皮质类固醇耐药血管瘤的早期消退。
Background and Methods. Most hemangiomas are small, harmless birthmarks that appear soon after birth, proliferate for 8 to 18 months, and then slowly regress over the next 5 to 8 years, leaving normal or slightly blemished skin. In rare cases, hemangiomas can endanger vital structures, with a mortality of up to 60 percent. About a third of these life-threatening hemangiomas respond to treatment with corticosteroids, but for the others there is no safe and effective treatment. We evaluated the effects of daily subcutaneous injections of interferon alfa-2a (up to 3 million units per square meter of body-surface area) in 20 neonates and infants with life-threatening or vision-threatening hemangiomas that failed to respond to corticosteroid therapy.Results. In 18 of the 20 patients the hemangiomas regressed by 50 percent or more after an average of 7.8 months of treatment (range, 2 to 13). One infant died of refractory proliferation of a lesion and consumptive coagulopathy. The condition of three other patients who had large hemangiomas associated with consumptive coagulopathies that were unresponsive to conventional therapies stabilized after seven days of treatment with interferon alfa-2a alone. Transient side effects of treatment with interferon alfa-2a included fever, neutropenia (one patient), and skin necrosis (one patient). No long-term toxicity has been observed after a mean follow-up of 16 months.Conclusions. Interferon alfa-2a appears to induce the early regression of life-threatening corticosteroid-resistant hemangiomas of infancy.