LM Research: Is Bleomycin Safe and Effective for Treating Microcystic LM?

This is going to be the first in a series of new posts in which I provide a brief rundown and summary of research articles on Lymphatic Malformation (LM), emphasizing what scientists have learned in recent years about this condition and what questions remain.

I plan to make these posts short, simple, and readable (free of scientific and medical jargon) so that the information I share will be useful to other LM families.

This first post will summarize the results of a recent study by researchers out of Boston Children’s Hospital on the effectiveness of Bleomycin Sclerotherapy for the treatment of microcystic LM.

I chose this article because it is extremely relevant to where we are at right now in our journey. Atticus has microcystic LM of the tongue and has so far undergone two rounds of Bleomycin injections at Arkansas Children’s Hospital.

Purpose:

Looks at the effectiveness of using bleomycin for microcystic lymphatic malformations.  There are concerns that bleomycin can lead to pulmonary fibrosis (irreparable lung scarring and damage).

Sample:

  • 31 patients
  • 10 males; 21 females
  • Mean age of 13.4 (range of 3 monts – 31 years)
  • Location of LM – head and neck (27 patients); abdomen/pelvis (4 patients)
  • Macrocystic/microcystic (22 patients); Microcystic (9 patients)

Method:

  • Repeat procedures performed 6 to 8 weeks apart
  • Mean number of procedures was 1.7 (range of 1 to 4)

Results:

Swelling was greater than anticipated for microcystic LM of tongue (steroids were given).  Response to treatment was measured at least 2 months after the last round of sclerotherapy.  Respiratory functioning was also assessed at certain intervals following the first procedure. The mean dose of bleomycin injected in a single session was 7.3 U, with a range of 1-15 U.  No abnormalities were found in follow-up chest X-rays.

Number (and %) of patients reporting each response type:

  • Complete response (greater than 90% of LM resolved) – 12 patients, or 38%
  • Partial response (25-90% of LM resolved) – 18 patients, or 58%
  • Minimal/no response (less than 25% of LM resolved) – 1 patient, or 3%

Conclusion:

Results show that sclerotherapy using bleomycin for microcystic LM appears safe and effective.

Limitations:

Small sample size

 

Reference:

Chaudry, G.,  Guevara, C.J., Rialon, K.L., Kerr, C., Mulliken, J.B., Greene, A. K., Fishman, S.J., Boyer, D., Alomari, A.I. (2014). Safety and Efficacy of Bleomycin Sclerotherapy for Microcystic Lymphatic Malformation. Cardiovascular and  Interventional  Radiology, 37, 1476–1481-1476–1481.

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