ObjectiveThe authors describe the use of interferon-alpha-2a in the treatment of complex hemangiomas and review the role of interferon (IFN) in this example of an angiogenic disease.
Summary Background DataHemangiomas are the most frequent tumors of infants and children. They grow rapidly for 6 to 8 months and then resolve over a period of years. Approximately 5% produce life-, sight-, or limbthreatening complications, with mortality rates between 20% and 50%. Aggressive therapy with steroids, arterial ligation or embolization, or surgery has been used in these situations with variable results and high morbidity. Recently, IFN-a was found to be effective treatment in these complex hemangiomas.
MethodsFour infants and one child were treated with IFN-a-2a at an initial subcutaneous dose of 1 million units/m2/day and a sustained dose of 3 million units/m2/day for 5 to 11 months. Appropriate laboratory values were monitored and adverse reactions and ultimate response to therapy were recorded.
ResultsTwo patients experienced minor complications that were managed easily. Three patients had total or near-total regression of the hemangioma, one had partial (50%) regression, and one had stabilization but no regression after an average of 7.1 months of IFN therapy.
Murine bone marrow was exposed to hyperthermia temperatures of 41.5 to 45.5°C. The proliferation capacity of myeloid progenitor and committed precursors was assayed in vivo utilizing spleen colony formation and diffusion chamber (DC) techniques. The survival of both pluripotential (CFU‐S) and committed myeloid (CFU‐DG) stem cells decreased exponentially with an increase in the heating period. Progression from CFU‐S to CFU‐DG significantly altered thermal sensitivity in the temperature range examined. Proliferation of mature granulocyte‐monocytes (G‐M) in DC is more thermostable than their stem cell precursors. Heat inactivation energies (enthalpies) of CFU‐S and CFU‐DG were derived from the slope of the heating time survival curves. Enthalpy of CFU‐S is 300 kcal/mole below 43° and 105 kcal/mole above 43°. The enthalpy of CFU‐DG is 250 and 145 kcal/mole below and above 43°, respectively.
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