For years the first line of treatment for Lymphatic malformation (aka cystic hygroma or lymphangioma) has been surgery to remove them. However these anomalies have a regrowth rate ranging from from 10% to 50%.

    In 1987 Dr Ogita published his first paper on the treatment of lymphatic malformation by using a biological response modifier which has been come to be known as OK-432/Picibanil. OK -432 is in clinical trials and may be used to treat macrocystic lyhpmangioma of the head and neck.  Cystic spaces must be at least 2.0 mL and be confirmed by radiographic imaging. 

    The reported success rate for OK-432 is about 90% to 95%. Optimal results occur when it is used prior to other treatment, with the most significant reduction in size noted. 

Link to OK-432 Articl by Dr. Ogita

OK-432 is in Clinical Research Trials- it is considered experimental and is not fully approved by the FDA

     OK-432 can be used in individuals that have had previous surgery with a less optimal result.  Physicians using OK-432 report a success rate of less then 90%. 

     OK -432 is injected while the patient is under general anesthesia in children.  Adults may select a localized anesthetic.    With the help of a fluoroscopic guidance a needle is placed into the cyst some of the fluid is aspirated from the cyst  and then Ok-432 is injected into the cyst (amount vareries on cyst, and the age of the patient) OK-432 is left in the cyst. This procedure usually takes about 45 minutes to an hour. Some patients maybe admitted to the hospital for 24 hour observation and others may elect to go home for recovery.

    Following the injection of ok-432, the body will start to react to the injection.  Side effects include: fever, increase in swelling of the malformation, pain.  These symptoms are easily managed with pain medications and are often a sign that the injection is working. 

     There are currently only a few centers where OK - 432 is being used in Clinical Trials.  The University of Iowa is the lead center for this clinical trial

If you would like more info on OK-432 click on the web sites below.

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http://www.clinicaltrials.gov/ct/gui/show/NCT00010452?order=1

http://www.uifoundation.org/hospitals/donor2.shtml http://www.uihealthcare.com/news/pacemaker/2004/winter/longdistancetherapy.html

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