Efficacy of transcatheter arterial chemoembolization combined with sirolimus for treating Kasabach-Merritt phenomenon in infants, a retrospective study

Ann Med. 2023 Dec;55(1):2196090. doi: 10.1080/07853890.2023.2196090.

Abstract

Objective: This retrospective study aimed to observe the efficacy of transcatheter arterial chemoembolization (TACE) combined with sirolimus in the treatment of haemangioma combined with the Kasabach-Merritt phenomenon (KMP).

Methods: A total of 11 infants with KMP who were treated at our hospital from January 2016 to September 2021 were selected and treated with arteriosclerosis embolotherapy using a microsphere emulsion formed by bleomycin + ultra-fluid lipiodol + dexamethasone + contrast agent or bleomycin mixed microspheres as the embolising agent. The patients were administered sirolimus orally after TACE. The clinical efficacy and examination indicators before and after treatment were observed and compared.

Results: The 11 infants underwent TACE treatment by arteriosclerosis embolotherapy a total of 21 times; of these cases, 10 were cured, and 1 showed a moderate response. There were no cases of non-response or death. The platelet count rose from 10.0 (7.0, 18.0) x 109/L before TACE to 236.0 (188.0, 275.0) x 109/L six months after the first TACE, and the tumour size decreased from 49.0 (43.0, 111.7) cm3 before TACE to 7.0 (3.5, 17.0) cm3 six months after the first TACE. The differences were statistically significant (the Z values were -2.943 and -2.934, respectively, p < 0.05).

Conclusion: The combination of TACE and sirolimus has significant efficacy on critical children with KMP.

Keywords: Kaposiform haemangioma; Kasabach–Merritt phenomenon; TACE; sirolimus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bleomycin / therapeutic use
  • Carcinoma, Hepatocellular*
  • Chemoembolization, Therapeutic*
  • Child
  • Hemangioendothelioma* / diagnosis
  • Hemangioendothelioma* / drug therapy
  • Humans
  • Infant
  • Kasabach-Merritt Syndrome* / diagnosis
  • Kasabach-Merritt Syndrome* / drug therapy
  • Liver Neoplasms* / therapy
  • Retrospective Studies
  • Sarcoma, Kaposi* / diagnosis
  • Sarcoma, Kaposi* / drug therapy
  • Sirolimus / therapeutic use

Substances

  • Sirolimus
  • Bleomycin

Grants and funding

This study was funded by the Anhui Provincial Health Commission project.