Combined Antiproliferative Therapy With Rapamycin and Propranolol for Giant Congenital Lymphangioma

Cîrstoveanu, Cătălin; Bizubac, Mihaela; Barascu, Ileana; Manolache, S.; Nine, L.; Istrate-Barzan, A.; Spătaru, Radu-Iulian; Marcu, Veronica

doi:10.1016/j.chest.2020.05.386

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“…In the last few years, multiple cases have been reported for the safety of sirolimus as a therapeutic option for various congenital vascular anomalies (9,10,12,(17)(18)(19)(20)(21)(22)(23). The phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway is pivotal for cellular functions such as growth and survival and has been demonstrated to be involved in normal vascular development and angiogenesis (24,25).…”

Section: Antiproliferative Therapy With Sirolimus and Propranolol For Congenital Vascular Anomalies In Newborns (Case Reports)mentioning

confidence: 99%

Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports)

et al. 2021

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We present a series of four newborns diagnosed with complicated congenital vascular anomalies, with different localization: Congenital lymphatic malformation (CLM) on the left hemithorax extending on the left upper limb; congenital hepatic hemangioma (CHH) with important complications in the first 7 weeks of life; Kaposiform hemangioendothelioma (KHE) of the left lower limb complicated with Kasabach Merritt phenomenon (KMM) and most probable diffuse capillary malformation with overgrowth (DCMO). All patients were treated with combined antiproliferative therapy with sirolimus and propranolol. The initial dose of sirolimus was 0.45-0.5 mg/m 2 with doses adjusted according to plasmatic levels. Therapeutic intervals of sirolimus were considered at plasmatic levels of 7-12 ng/ml. Our aim was to use the lowest therapeutic dose in order to avoid possible side effects. Propranolol was initiated in doses of 0.5-1.0 mg/kg/day and was increased up to 3.0 mg/kg/day depending on tolerability. Following two months, every patient showed a marked reduction in the size of the mass, improvement in overall appearance or even calcification in the liver vascular tumor. No patient showed life threatening side effects to the treatment. Hypertriglyceridemia was the only side effect noted in all patients. This is in accordance with several international studies, which try to demonstrate the importance of sirolimus in neonatal vascular malformations in monotherapy or combined with different drugs.

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Section: Antiproliferative Therapy With Sirolimus and Propranolol For Congenital Vascular Anomalies In Newborns (Case Reports)mentioning

confidence: 99%

Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports)

et al. 2021

View full text Add to dashboard Cite

show abstract

Combined Antiproliferative Therapy With Rapamycin and Propranolol for Giant Congenital Lymphangioma

Cited by 1 publication

References 0 publications

Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports)

Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports)

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