Additive value of single intralesional bleomycin injection to propranolol in the management of proliferative infantile hemangioma

Asian J Surg. 2024 Jan;47(1):154-157. doi: 10.1016/j.asjsur.2023.05.170. Epub 2023 Jun 15.

Abstract

Background: /Objective: We aimed to evaluate whether additional intralesional bleomycin injections benefit children with proliferative infantile hemangiomas (IHs).

Methods: In this retrospective case-control study, we examined the medical records of 216 infants who were followed up for proliferative IH. Patients in group 1 were treated with propranolol orally at 2 mg/kg/day. Group 2 was treated with oral propranolol combined with intralesional bleomycin injections.

Results: We retrospectively reviewed 95 and 121 patients in groups 1 and 2, respectively. No significant differences were observed between both groups regarding visiting age, sex, lesion thickness, or risk site. The overall cure rates in groups 1 and 2 were 77.89% (74/95) and 84.30% (102/121), respectively. The overall distribution of the length of cure significantly differed between both groups (P = 0.035). From the survival analysis (P = 0.026), the median survival time was 198 days (95% confidence interval (CI) 174.46-221.54) for group 1 and 139 days (95% CI 114.58-163.42) for group 2. The effect of treatment modality (hazard ratio (HR) = 1.41, P = 0.031) and risk site on survival time (HR = .54, P < 0.001) was significant.

Conclusion: No significant differences were observed in the resolution of proliferative IH; however, intralesional bleomycin injection with systemic propranolol for proliferative IH treatment may provide a more rapid resolution.

Keywords: Bleomycin; Infantile hemangioma; Intralesional; Management; Propranolol.

MeSH terms

  • Administration, Oral
  • Bleomycin / therapeutic use
  • Case-Control Studies
  • Child
  • Hemangioma, Capillary* / chemically induced
  • Hemangioma, Capillary* / drug therapy
  • Humans
  • Infant
  • Propranolol* / adverse effects
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Propranolol
  • Bleomycin