OC-18 Propranolol treatment in infantile hemangioma – a five year study

Abstract

Background and aims Infantile hemangioma is a benign vascular tumour of infancy, affecting with a higher incidence the premature infants and females. It is not possible to predict the final size of infantile hemangioma, or eventual complications. Different treatments have been suggested, such as systemic corticosteroids, interferon-alpha, cyclophosphamide, vincristine. There is no consensus concerning the first-choice treatment for infantile hemangioma. Propranolol, a nonselective β-blocker, having complex mechanisms of action, seems to be effective and safe as first-line therapy for infantile hemangioma. This study aims to analyse the effectiveness and safety of Propranolol treatment for infantile hemangioma. Methods This study prospectively evaluated patients with infantile hemangioma, admitted over a 5 year period in a paediatric department. Patients were analysed for gestational age, gender, age at first presentation, hemangioma location, number and size, complications and outcome. Results The study group consisted in 43 patients (65.1% girls), 90% infants, who presented 65 infantile hemangioma. Five patients (11.6%) were born preterm. Most hemangioma were located on the head (58.4%). Five hemangioma presented ulcerations or infection as complications, before treatment. Ultrasonography offered the correct diagnosis in the evaluated cases. Magnetic resonance imaging completed the diagnosis in 2 cases. Propranolol treatment was chosen based on hemangioma location, size, number, proximity to eye, nose, parotid region. Propranolol was given at a dose of 2 mg/kg/day and continued for at least 6 months. 70% of patients recorded good results after 6 months treatment. The first observed effects were the changes in colour and softening of hemangioma. We recorded as side effects unremarcable hypoglicemia in 3 patients. Conclusion Our study proves that Propranolol is a safe and effective first-line therapy for infants with infantile hemangioma. More studies with larger number of cases are necessary to confirm these data.