Clinical observations in mesh suture treatment for infants of <scp>K</scp>asabach–<scp>M</scp>erritt phenomenon

Li, Ke-lei; Ma, Tai; Qin, Zhongping; Ge, Chunxiao

doi:10.1111/jpc.12743

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…In their study, vincristine had the best efficacy rate (62%) in treating 24 infants. Recently, large clinical studies have reported that vincristine is an effective treatment option, especially for steroid‐resistant KHE . Studies of patients treated by interferon 2a or 2b and radiotherapy were also included in our meta‐analysis.…”

Section: Discussionmentioning

confidence: 99%

Treatment of kaposiform hemangioendothelioma and tufted angioma

Liu

et al. 2016

Intl Journal of Cancer

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This meta-analysis was to evaluate the efficacy of current treatment modalities for kaposiform hemangioendothelioma and tufted angioma. A systematic review was performed using PubMed (Medline), Web of Science and Embase for clinical studies. The outcome was measured by pooled response rate with 95% confidence intervals (CIs), together with heterogeneity, subgroup analysis, sensitivity analysis and publication bias. Fifteen studies with 244 participants were included in this analysis. Vincristine therapy exhibited a relatively higher response rate (0.72; 95%CI, 0.64-0.79) compared with other therapies including systemic corticosteroid (0.27; 95%CI, 0.17-0.36), interferon (0.36; 95%CI, 0.24-0.48), radiotherapy (0.49; 95%CI, 0.26-0.73), embolization (0.66; 95%CI, 0.48-0.83), aspirin/ticlopidine (0.42; 95%CI, 0.06-0.78) and sirolimus (0.57; 95%CI, 0.00-0.10), in treating KHE/TA. Subgroup analysis indicated that the efficacy of systemic corticosteroids therapy was age-related. The pooled response rate was 0.15 (95%CI, 0.08-0.23) for participants 3.5 months of age and older compared with 0.35 (95% CI, 0.26-0.44) for participants less than 3.5 months. Regarding side effects, systemic corticosteroids treatment was 0.32 (95%CI, 0.15-0.50), vincristine modality was 0.16 (95%CI, 0.08-0.24) and interferon therapy was 0.28 (95%CI, 0.13-0.43). In conclusion, as one of the first reviews evaluating the effect of common therapies in the treatment of KHE/TA, our meta-analysis displayed that vincristine was more effective. Thus, vincristine was the most effective, providing evidence supporting the use of vincristine as a first-line therapy for KHE/TA.

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Section: Discussionmentioning

confidence: 99%

Treatment of kaposiform hemangioendothelioma and tufted angioma

Liu

et al. 2016

Intl Journal of Cancer

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“…However, clinical outcomes have not improved due to limited efficacy, high recurrence possibilities, high risks of adverse reactions and iatrogenic tissue defects (7,35–38). Previously, mesh suture treatment was observed to be effective in the management of KMP (39); however, a more specific association between mesh sutures and KHE was not clearly reported, as only 1 patient in the series was pathologically diagnosed with KHE. In the present study, the reported cases were based on definite pathological KHE diagnoses and were characterised by extremely low PLT levels, partial drug sensitivities, larger tumour types compared with benign lesions, high resection trauma and high potential mortality risks.…”

Section: Discussionmentioning

confidence: 91%

Local suture ligation‑assisted percutaneous sclerotherapy for Kasabach‑Merritt phenomenon‑associated kaposiform haemangioendothelioma

Wen

et al. 2018

Oncol Lett

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Kaposiform haemangioendotheliomas (KHEs) complicated by the Kasabach-Merritt phenomenon (KMP) are rare and severe neoplastic lesions often associated with locally aggressive disease, consumption coagulopathy and high mortality rates. Current regimens have yet to achieve a satisfactory therapeutic effect. Thus, an effective and minimally invasive approach for treating complex KHE/KMP cases is necessary for clinical management. The present case series describes patients with KHE/KMP who underwent local suture ligation-assisted percutaneous sclerotherapy to minimise surgical trauma and ensure effective treatment. Between September 2015 and September 2017, 3 consecutive patients with KHE/KMP underwent staged local suture ligation-assisted percutaneous sclerotherapy. Of these patients, 2 presented with medical histories of corticosteroid treatment with unsatisfactory outcomes. The patients underwent a stepwise synthetic serial therapy programme consisting of percutaneous sclerotherapy and adjunctive pharmacotherapy accompanied by a suture ligation procedure. Clinical, radiological, pathological and laboratory data were analysed to evaluate the outcomes of the therapy. All patients were successfully managed with the proposed procedure. Significant relief of clinical symptoms and improvements in haematological indicators were achieved. No recurrence or complications were observed during regular follow-up (4, 19 and 28 months). In conclusion, local suture ligation-assisted percutaneous sclerotherapy was demonstrated to be a safe and effective treatment for KHE/KMP, being minimally invasive, involving simple manipulation and providing a clear treatment benefit in certain cases. Further studies involving larger sample sizes are required to thoroughly evaluate the procedure, which can potentially be used as a novel therapeutic option for KHE/KMP treatment.

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“…Kasabach-Merritt syndrome (KMS) is a vascular disease characterized by the presence of thrombocytopenia, anemia, disseminated intravascular coagulation (DIC), and vascular lesions. It was first described in 1940 by 2,3]. KMS often occurs during infancy and the neonatal period and rarely in adults [1,2,4].…”

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confidence: 99%

“…It was first described in 1940 by 2,3]. KMS often occurs during infancy and the neonatal period and rarely in adults [1,2,4]. KMS is commonly associated with kaposiform hemangioendothelioma and tufted angioma, which are rare vascular tumors produced by the lymph and capillary endothelium with positive immunohistochemical staining for vascular markers (CD31, CD34) and focal positivity for lymphatic markers (LYVE1, PROKS1, D2-40), while they are negative for GLUT1 and Lewis Y antigen (markers specific to hemangiomas) [1,5].…”

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confidence: 99%