Clinical treatment of Kaposiform hemangioendothelioma
10.3760/cma.j.cn114453-20191013-00304
- VernacularTitle:卡波西型血管内皮瘤的临床治疗分析
- Author:
Lizhen LIU
1
;
Yide XIE
;
Mingkun ZHAN
Author Information
1. 福建医科大学附属协和医院整形美容外科，福州 350000
- Keywords:
Kaposiform hemangioendothelioma;
Kasabach-Merritt syndrome;
Platelet count;
Laboratory critical values
- From:
Chinese Journal of Plastic Surgery
2020;36(11):1258-1263
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To discuss the clinical treatment methods of Kaposiform hemangioen-dothelioma (KHE).Methods:Eleven children with KHE admitted to the Union Hospital of Fujian Medical University from November 2009 to November 2015 were retrospectively analysed. Children aged from 5 days to 2 years old, 8 males and 3 females. In the treatment of cases 1-5, glucocorticoids and propranolol were routinely used for treatment regardless of the platelet count. The glucocorticoids was taken orally 4.0-4.5 mg/kg every other day, and the maximum daily dose of propranolol was 2 mg/kg given by three times a day. In the treatment of cases 6-11, the critical value of platelets number was 20×10 9/L. For those higher than the critical value, glucocorticoids and propranolol were routinely given. For those lower than the critical value, under the premise of taking glucocorticoids and propranolol, sirolimus was givenorally by the dose of 0.8 mg/m 2 twice a day. Two of the children had been treated with vincristine at a dose of 0.05 mg/m 2. The treatment effect was observed and followed up. Results:Followed up for three to eight years. Three of eleven cases did not get thrombocytopenia, and the effect of glucocorticoids combined with propranolol treatment was good. One case’s platelets number was 20×10 9/L. The tumor dissappered after treated with glucocorticoids combined with propranolo. Seven cases with platelets was lower than the critical value. Five in seven cases were treated with glucocorticoids, propranolol and sirolimus. The effect was good. One case, treated with glucocorticoids, propranolol and vincristine, died of cerebral hemorrhage. Another one case was lost to follow-up after treatment with glucocorticoids and propranolol. Conclusions:With the critical value of platelet criticality, patients above this value are routinely treated with glucocorticoid and propranolol first while those below this value are treated with sirolimus while taking glucocorticoids and propranolol. Through this method, better results can be achieved.
