Intralesional Bleomycin Injection Research Articles

Assessment the Outcome of Intralesional Bleomycin Injection, dehydrated (95%) Alcohol and Combined of Them in Managements of Orofacial Vascular Malformation

Assessment the Outcome of Intralesional Bleomycin Injection, dehydrated (95%) Alcohol and Combined of Them in Managements of Orofacial Vascular Malformation

Treatment of keloids with intralesional injection of bleomycin and triamcinolone acetonide

A keloid is a kind of overgrown scar due to aggressive healing response to a wound. Satisfactory management of keloid has always been a challenge. In this study we aimed to evaluate the efficacy of combination of intralesional bleomycin and triamcinolone acetonide in the treatment of keloids. Study on 20 clinically diagnosed lesions of keloids from 12 patients was conducted. Excellent response was seen in 70%, good response was seen in 10%, fair response was seen in 15%, poor response was seen in 5%. The main side effects observed were pain(100%), hyperpigmentation (50%), ulceration (15%), atrophy(5%).

Intralesional injection of bleomycin in the treatment of xanthelasma palpebrarum: A clinical study.

Xanthelasma palpebrarum (XP) is the most common type of cutaneous xanthoma and has been treated with intralesional injection of pingyangmycin effectively. However, bleomycin, which has the same effect in antitumor activity as pingyangmycin, has not been applied in the treatment of XP. To explore and assess the treatment of xanthelasma by intralesional injection of bleomycin, which has been widely used as an antitumor antibiotic, for the replacement of pingyangmycin. Intralesional injection of different concentrations of bleomycin was administered to 44 xanthelasma lesions of 24 patients who have never been treated before, divided into two groups according to age. Photographs were taken and analyzed to assess the therapeutic efficiency. Patients were then followed up for 6-24months. All the lesions resolved after 1month of treatment with the intralesional injection of different concentrations of bleomycin. There was no significant difference observed between the two groups. No severe complications had occurred. The treatment of XP with intralesional injection of bleomycin is minimally invasive, safe, and effective. Consequently, it also has good cosmetic outcome with no adverse effects.

Evaluation of the Results of Intralesional Bleomycin Injection for Treatment of Haemangioma and Vascular Malformation

Evaluation of the Results of Intralesional Bleomycin Injection for Treatment of Haemangioma and Vascular Malformation

A comparative study of intralesional injection of Candida albicans antigen, bleomycin and 5-fluorouracil for treatment of plane warts

Background Several therapeutic modalities for the treatment of verruca plana (VP) are available, but none has achieved complete cure in all cases with associated risk of side effects. Objective To evaluate efficacy and safety of intralesional injection of Candida albicans (C. albican) antigen, bleomycin and 5-fluorouracil (5-FU) in treatment of VP. Methods Sixty patients with VP were randomly divided into three equal groups who were treated using C. albicans antigen, bleomycin or 5- FU injections every 2 weeks till complete clearance of the lesions or for a maximum of four sessions and followed up for additional 8 weeks. Results A statistically significant higher incidence of complete response was achieved with bleomycin (85%) than C. albicans antigen (60%) which was higher than 5-FU (45%) with a significantly less number of required sessions to achieve best results with bleomycin and candida antigen than 5-FU. Conclusions Candida albicans antigen, bleomycin and 5-FU are helpful modalities for treatment of VP. Bleomycin was the most effective, followed by C. albicans antigen then 5-FU (least effective). Single injection site, clearance of distant warts and decreased incidence of new lesion development – in situ or elsewhere – are additional merits of C. albicans immunotherapy. These modalities are cheap with only transient adverse effects.

Therapeutic efficacy of intralesional bleomycin injection for laryngopharyngeal haemangioma in adults

Background: Head and neck haemangiomas in the pharynx and larynx are rare, and the injection of bleomycin is currently one of the effective treatments. However, data on the therapeutic efficacy of this treatment are scarce.Objectives: To evaluate the clinical efficacy of bleomycin injection in the treatment of laryngopharyngeal haemangioma in adults and determine factors affecting efficacy.Materials and Methods: The clinical data of 42 adult patients with laryngopharyngeal haemangioma treated by intralesional bleomycin injection were retrospectively analysed to evaluate the clinical efficacy. Two groups (haemangioma reduction <50% and haemangioma reduction ≥50%) were compared to analyse factors affecting efficacy.Results: Seventy-five injections were administered to 42 patients: 34 (34/42 81%) patients with a haemangioma reduction ≥50% and 8 (8/42 19%) with a haemangioma reduction <50%. There was no difference in age, sex, haemangioma shape or number of operations between the two groups, but there was a significant difference in the base area of the haemangioma.Conclusions and Significance: Intralesional bleomycin injection is effective for the treatment of laryngopharyngeal haemangioma in adults. The base area of the haemangioma affects the therapeutic efficacy.

Infantile hemangioma: Efficacy of low-dose propranolol and of intralesional bleomycin injection for propranolol non-response.

Infantile hemangioma (IH) is the most common form of benign childhood vascular tumor. Most resolve spontaneously, but treatment is recommended in patients who develop complication. Propranolol is recommended as the first-line therapy, while the treatment in the case of non-response to first-line therapy depends on the clinical experiences of each center. The aim of this study was to investigate the efficacy of low-dose propranolol in the treatment of IH, and the outcomes of percutaneous intralesional bleomycin injection (IBI) in patients unresponsive to propranolol. Medical records of 104 children diagnosed with IH between June 2014 and June 2017 were reviewed retrospectively. Median patient age was 6months (range, 3-12months). Forty-five patients (43.3%) received therapy: 18 (40%) for cosmetic problems and 27 (60%) for lesion-related complications. The most common complications were hemorrhage (15.6%) and impairment in visual function (15.6%). All of the patients received propranolol 1 mg/kg/day as the first-line therapy. Response to treatment was excellent in 35 patients, good in four and poor in one, while five patients did not respond to therapy. The five unresponsive patients received percutaneous IBI at 0.3-0.5mg/kg/dose as second-line therapy. The response to treatment was excellent in four patients, good in one. The majority of IH resolved spontaneously. In the patients who required treatment, low-dose propranolol was successful in most, and IBI was effective and safe in the remaining five patients who did not respond to propranolol.

Therapeutic evaluation of efficacy of intralesional bleomycin in common warts including palmo-plantar and periungual warts: a prospective study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Commonly used destructive treatment modalities for common warts though effective, are associated with pigmentary changes, scarring and recurrences. Treatment with immune modulators or immunotherapy has shown variable results. We evaluated efficacy and safety of intralesional bleomycin for treating common warts including palmoplantar and periungual warts.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Two hundred patients with common, palmar, plantar and periungual warts (having 753 warts) were treated with two intralesional injections of bleomycin 1 mg/ml at two weekly intervals. They were followed up at 4weeks and 12 weeks for cure, adverse effects and partial clearance or recurrence.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Only 183 (M: F 95:88) patients having 703 warts completed the study. Overall, complete clearance in 669 (95.16%) warts in 156 (85.2%) patients and partial clearance in 24 (3.4%) warts in 21 (11.4%) patients were observed. Patients with complete/partial clearance were highly satisfied from the treatment. Recurrence was seen in 6 (3.27%) patients. Most patients had injection site pain for 2-3 days not warranting discontinuation of treatment. Other adverse effects included temporary hyperpigmentation in 46, altered skin texture in 12 and injection site infection in 6 patients, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Intralesional bleomycin appears effective, safe, and acceptable treatment modality for common warts including palmoplantar and periungual warts. It carries the advantage of low dose, insignificant adverse effects and high patient satisfaction. &lt;/p&gt;

Results of Intralesional Bleomycin Sclerotherapy for Treatment of Orbital Lymphangiomas at a Tertiary Eye Care Centre in Bangladesh

Purpose: The purpose of our study was to evaluate the role of intralesional bleomycin injection for the treatment of orbital lymphangiomas. Methods: This was a prospective interventional case study. Twelve patients diagnosed with orbital lymphangiomas received intralesional bleomycin injection at a dose of 0.5 mg/kg body weight (maximum 15 mg) along with lignocaine 2%. Those who required retreatment were injected at intervals of 4 weeks. The outcome was reviewed radiologically and using serial photographic comparison. Result: Proptosis and lid swelling were the most frequent presentations. The number of injections ranged from 1 to 3. Fifty percent of our patients showed complete resolution, and the other 50% showed more than 70% resolution as evidenced radiologically and on digital photography. Conclusion: No significant ophthalmic or systemic side effect was noticed in our study group. Therefore, intralesional bleomycin injection can be considered as first-line therapy for treatment of orbital lymphangiomas.

A rare case of orbital lymphangioma with persistent fetal vasculature and extraorbital vascular malformations treated with intralesional bleomycin

Orbital lymphangiomas are isolated, benign vascular malformations of childhood. We report a case of orbital lymphangioma with acute intralesional hemorrhage in a 4-year-old boy that was associated with ipsilateral persistent fetal vasculature and extraorbital vascular malformations. Complete resolution of orbital lesion was achieved with chocolate cyst aspiration and intralesional injection of bleomycin.

Evaluation of intralesional injection of bleomycin in the treatment of plantar warts: clinical and dermoscopic evaluation.

Treatment of plantar warts is difficult and requires multiple treatments, and they are more refractory to treatment than common warts. Intralesional bleomycin has been used in the treatment of warts with varying degrees of success. The aim of the present work is to evaluate the efficacy of intralesional injection of bleomycin in the treatment of plantar warts based on clinical and dermoscopic observations. Bleomycin (1 mg/ml) was injected intralesionally into the pared plantar wart every 2 weeks for a maximum of four sessions. Patients were followed both clinically and by the use of dermoscope. The cure rate of plantar warts treated with bleomycin was 69.3% with minimal and tolerable side effects. Intralesional injection of bleomycin is an effective and safe treatment of plantar warts. Dermoscope is recommended in the evaluation of treatment success, as it can accurately tell if the wart needs further treatment, preventing premature stoppage of the treatment, thus decreasing the possibility of recurrences.

Intralesional Bleomycin injection in head and neck haemangioma and vascular malformation: A nonsurgical treatment

Background: Successful management of vascular anomaly of head and neck region are often challenging. As the surgical modality carries high complications and bad aesthetic outcome, the treatment paradigm for these lesions has been shifting towards the non-invasive one. Because of its high sclerosing effect on vascular endothelium, low cost and easy availability intralesional Bleomycin injection can be an alternative.Objective: To determine the efficacy and safety of intralesional Bleomycin sclerotherapy for head and neck haemangioma and slow flow vascular malformation.Methods: Thirty-six patients (12 males and 24 females) with head and neck haemangioma and slow flow vascular malformations were treated with intralesional Bleomycin injection in the dose of 0.5mg/kg/dose (not exceeding 15 mg/dose) in a medical college of Nepal. The repeat injection was offered every three weeks if needed. The size of the lesion was measured and serial photographs were taken. Complications were also recorded.Results: Ten patients (28%) had complete resolution (cured), 19 patients (53%) had marked improvement five (14%) had mild improvement and two (6%) had no response. Minor complications like fever and transient rise in temperature were seen in eight patients (22%). Hyperpigmentation of the overlying skin were observed in four (11%). None of the patients developed haematological toxic side effects or pulmonary fibrosis during the follow up.Conclusion: Intralesional Bleomycin injection is simple, safe, effective and non-invasive modality of the treatment for head and neck haemangioma and slow flow vascular malformation.

Successful intralesional bleomycin injections for the management of a huge life-threatening cervical lymphangioma in a 3-day-old neonate

Intralesional bleomycin injections (IBI) for the management of a huge life-threatening cervical cystic hygroma is superior to surgery. Surgery has a high rate of morbidity and even mortality. Recurrence and injury to major vessels, nerves, and lymphatics may be unavoidable. The authors report on a 3-day-old male infant who was diagnosed antenatally as a case of a huge cervical cystic hygroma. Postnatally, the patient required mechanical ventilation. The patient was treated successfully with IBI without complications. To our knowledge, this is the youngest case presenting acutely to be treated successfully with IBI without complications. Keywords: bleomycin, neonatal cystic hygroma, respiratory distress

Percutaneous treatment of orofacial vascular malformations

The aim of this study was to evaluate the efficacy of fluoroscopy-guided percutaneous injection of bleomycin as the primary treatment for low-flow vascular malformations. A total of 34 patients (mean (range) age 24 (8–51) years) with orofacial vascular lesions were treated in the Department of Interventional Radiology and Maxillofacial Surgery. There were 20 low-flow venous malformations, 11 lymphatic malformations, and three of mixed type. All patients were treated by fluoroscopy-guided percutaneous injection of a mixture of bleomycin (mean (range) 15 (5–15)mg) and a radio-opaque agent (Ultravist® (iopromide), Bayer)/session. The number of sessions ranged from one to six. The clinical response was complete in 21 patients, obvious in nine, and of clinical benefit in four. Patients were reviewed within the first week, third week, and at three-month periods until 24 months. There were no serious complications such as pulmonary fibrosis. Fluoroscopy-guided intralesional injection of bleomycin should be considered as the first-line treatment for lymphatic malformations because it is effective and reliable with few complications.

Successful Treatment of a Keratoacanthoma with Electrochemotherapy: A Case Report.

IntroductionFew studies have evaluated the efficacy of intralesional bleomycin injection combined with electroporation for the treatment of cutaneous tumors. However, the phenomenon that electroporation can enhance the cytotoxicity of bleomycin in vivo by 300–700 fold has been intensely investigated.Case PresentationKeratoacanthoma in an 86-year-old patient was treated with intralesional bleomycin combined with electroporation. Treatment consisted of local application of shorty and intense electric pulses followed by local injection of bleomycin. Electroporation was always well tolerated by the patient, with no significant complaints, and the tumor had completely regressed by day 71 of the follow-up.ConclusionThe results suggest that intralesional bleomycin injection combined with electroporation could represent a valid alternative therapeutic approach for the treatment of keratoacanthomas.

Bleomycin Sclerotherapy in Lymphangiomas of Head and Neck: Prospective Study of 8 Cases.

The aim of this study is to evaluate the role of bleomycin as a primary mode of nonsurgical treatment in lymphangiomas of head and neck and study their complications. This is a prospective study of 8 patients diagnosed with lymphangioma of head and neck presenting to ENT department of Tata main Hospital from December 2014 to January 2017. They were clinically and radiologically evaluated and treated with intralesional injection of bleomycin diluted in normal saline. Complete resolution was seen in 62.5% (5/8) of patients, 25% (2/8) had good response while 12.5% (1/8) had a poor response. No major complications were noted apart from fever and inflammation. Intralesional bleomycin can be used as a primary modality of treatment.

Intralesional bleomycin in lymphangioma circumscriptum of tongue

Lymphangioma circumscriptum is a congenital lymphatic malformation of superficial lymphatics. It may present at any age but is usually noted at birth or appears during childhood. The usual sites of presentation are head and neck; oral cavity is rarely involved. Very few cases of lymphangioma circumscriptum of the tongue are reported. The diagnosis is confirmed by histopathology. The usual treatment for such cases includes local excision or sclerotherapy. We present a case of symptomatic lymphangioma circumscriptum of the tongue in a 15-year-old boy who was treated by debulking of lesion, followed by intralesional injections of bleomycin.

Treatment of Early-stage Extracranial Arteriovenous Malformations with Intralesional Interstitial Bleomycin Injection: A Pilot Study.

Purpose To assess the efficacy and safety of intralesional interstitial bleomycin injection in the treatment of early-stage (Schobinger stage I or II) extracranial arteriovenous malformations (AVMs). Materials and Methods This prospective study involved 34 patients with early-stage AVMs, as defined by the Schobinger staging system. The patients received intralesional interstitial bleomycin injected at a maximum dose of 15 000 IU or 1000 IU per kilogram of body weight for children who weighed less than 15 kg per procedure for a total of 6 months (once every month). Therapeutic outcome was evaluated by the degree of devascularization at angiography and the clinical outcome 3 months after the last treatment. Further follow-up was evaluated based on further clinical outcome. Adverse events were recorded according to the Society of Interventional Radiology classification. Results Of the 34 patients with early-stage AVM, 32 (mean age, 20.5 years; 24 female [75%]) completed the study. The results showed that 27 (84.4%, 95% confidence interval [CI]: 71.1, 97.7) patients were responsive to bleomycin injection, including nine (28.1%) with a complete response. Four (12.5%) patients showed no response, and one (3.1%) patient experienced worsening 3 months after the last treatment. During further follow-up (mean follow-up time, 20.7 months; range, 5-28 months), the outcome remained stable in 31 (96.9%) of the 32 patients. A major complication, anaphylactic shock, was observed in one (3.1%, 95% CI: 0, 9.5) patient. Common minor complications included hyperpigmentation, nausea, pruritus, and bullae. Conclusion Intralesional interstitial bleomycin injection is a feasible approach for early-stage AVMs and yields safe and effective outcomes. © RSNA, 2017.

Electrosclerotherapy for capillary malformations: study protocol for a randomised within-patient controlled pilot trial

IntroductionThe current state-of-the-art treatment modality for hypertrophic capillary malformations (CMs), laser therapy, has a considerable rate of non-responders and recurrence. Intralesional bleomycin injections (or ‘sclerotherapy’) are commonly used to treat...

Treatment of Tongue Lymphangioma with Intralesional Combination Injection of Steroid, Bleomycin and Bevacizumab.

Lymphangioma is a congenital malformed lymphatic tumor that rarely involves the tongue. In our clinic, a 10-year-old female presented with lymphangioma circumscriptum involving the right two-thirds of the tongue. We administered an intralesional combination injection of triamcinolone, bleomycin, and bevacizumab as a treatment. Almost complete remission after combination therapy was achieved without complications such as edema, swallowing difficulties or recurrence. Bevacizumab, an inhibitor of vascular endothelial growth factor, was effective for the treatment of lymphangioma of the tongue in this case. No recurrence was noted at the 1-year follow up.