OK-432 therapy for lymphatic malformation in 32 patients (28 children)

Claesson, Gösta; Kuylenstierna, Richard

doi:10.1016/s0165-5876(02)00117-9

Cited by 51 publications

(33 citation statements)

References 10 publications

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“…Previous reports have stated that surgical 86 Motz et al, OK432 Versus Doxycycline for Lymphatic Malformations excision is not more complicated after OK432 sclerotherapy. 2,3,[22][23][24]27,28 We found this to be true in the excision of an organized hematoma.…”

mentioning

confidence: 70%

OK432 Versus Doxycycline for Treatment of Macrocystic Lymphatic Malformations

Motz

Nickley

Bedwell

et al. 2014

Ann Otol Rhinol Laryngol

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Objectives: A variety of sclerotherapy agents are used to treat macrocystic lymphatic malformations (LMs). This retrospective study at a single institution was performed to compare the outcomes of pediatric macrocystic LMs of the head and neck that were treated with doxycycline or with OK432. Methods:The outcomes measured included early response to therapy, number of treatments required, operating room time, and adverse events. Results:The rates of clinical success for OK432 and doxycycline were similar (83% and 82%, respectively; p > 0.05), although OK432-treated patients required more treatments than did doxycycline-treated patients (1.9 versus 1.0 injections; p = 0.01; 95% confidence interval, 1.57 to 0.27). The average operating room time for a single OK432 injection was significantly shorter than that for doxycycline (53.2 versus 98.1 minutes; p < 0.001); however, when the total number of treatments administered was considered, the overall times in the operating room were similar. Adverse events in the early postoperative period were more common in OK432-treated patients, who experienced marked postoperative swelling compared to doxycycline-treated patients.Conclusions: OK432 and doxycycline are both effective sclerosants for the treatment of predominantly macrocystic LMs. The administration time for OK432 is shorter than that for doxycycline, but OK432 required more treatments overall to achieve clinical success. Early adverse events were more common in OK432-treated patients, but longer follow-up is necessary to determine whether rates of recurrence and adverse events are similar, particularly in light of the risk of tooth discoloration in doxycycline-treated patients.

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confidence: 70%

OK432 Versus Doxycycline for Treatment of Macrocystic Lymphatic Malformations

Motz

Nickley

Bedwell

et al. 2014

Ann Otol Rhinol Laryngol

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“…In the extreme cases of large fetal lymphangiomas there is an increased risk for a hypoxic insult or even death immediately after birth, because of the inability to establish an airway for the newborn. [3,4,13] Surgery in infancy carries substantial risks [14] . Complete removal is sometimes impossible in cases when lymphangiomas involve adjacent vital structures, including cranial nerves, major vascular structures, hypopharynx, or trachea.…”

Section: Discussionmentioning

confidence: 99%

“…When OK-432 is used as primary therapy, complete resolution may occur in 50-90% [14,18,19] . No teratogenicity of OK-432 has so far been reported in humans.…”

Section: Discussionmentioning

confidence: 99%

Intrauterine Treatment of Large Fetal Neck Lymphangioma with OK-432

Mikovic¹,

Simić²,

Egić³

et al. 2009

Fetal Diagn Ther

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Lymphangiomas are benign vascular malformations of the lymphatic system and most commonly present in the neck area. Large lymphangiomas may compress and/or displace the larynx, trachea and esophagus and cause serious respiratory and feeding problems in neonates. Prenatal therapy could eliminate the risks of the mentioned complications. Prenatal therapy may include the EXIT (ex utero intrapartum treatment) procedure. As this procedure has certain risks for both the neonate and mother, the introduction of a safer method is justified. The use of OK-432, as a sclerosing agent, has shown positive results in several published cases of cystic hygroma, but there is no study about the prenatal use of this agent in the treatment of lymphangioma. The aim of this study was to present our experience with intrauterine intralesional injection of OK-432 in the treatment of neck lymphangiomas. Two cases of large multicystic neck lymphangiomas that were closely situated to the fetal airway were treated by single intralesional injection of OK-432. We noticed a progressive decrease in tumor volume throughout gestation. We did not experience any complications and there were no respiratory or feeding problems in the neonates. The esthetical appearance was satisfactory and both children were normal at the age of 2 years and 6 months, respectively. This report suggests that prenatal intralesional injection of OK-432 might be a safe and effective treatment in selected cases with large fetal neck lymphangiomas.

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“…Die unzureichende Wirkstoffverteilung bei fehlender intralä-sionaler Zirkulation begründet daher die geringe Ansprechrate der mikrozystischen Form. Lediglich Claesson u. Kuylenstierna [3] berichteten über eine erfolgreiche Therapie in allen untersuchten Patienten (n=4). Aufgrund eines nur 30%igen Therapieerfolgs bei makrozystischen lymphatischen Malformationen schlussfolgerten Hall et al [6] in ihrer Studie, dass Zysten größer 5 cm und solche, die außerhalb der Kopf-Hals-Region lokalisiert sind, weniger gut auf eine Picibaniltherapie ansprechen.…”

Section: Diskussionunclassified

“…Lymphatic malformation · Resection · Sclerotherapy · Lyophilized powder of Streptococcus pyogenes cells · Picibanil (OK- 432) solcher Vorgänge wird daher übereinstim-mend zu einer stationären Mindestüber-wachungszeit von 24 h geraten [1,3,12,13]. In 2 Fällen wurde von einer plötzlichen Größenzunahme der lymphatischen Malformation nach Picibanilapplikation berichtet, sodass die Patienten zur Sicherung der Atemwege tracheostomiert werden mussten [4,12].…”

Section: Introductionunclassified