While gloco-cortico steroids are the first line of treatment for Hemangioma, KHE and tufted Angioma their response rate is between 70-80%. In the remaing cases steroids are not effective.
For those patients that do not respond to steroids a relatively new therapy has shown to be effective in clinical data of 41vascular lesion patients reviewed in an international cooperative study. To date this is the only published study available.
Vincristine: is a drug that belongs to the group of medicines known as antieoplastic agents. It is a chemotherapy agent that has been used in cancer patients for a long time. This type of drug interferes with the growth of cells and eventually kills these cells. This process is called apoptosis
Vincristine is administered by injection, typically with a central venous line called a port-o-cath. The drug is injected once a week until improvement is noted and then the administration of the drug can be decreased. The main complications of this drug are constipation and jaw pain. The drug can have some neurotoxicity as well and therefore; the patient must be closely followed by a physician. Bilirubin levels should be monitored.
Before starting this medication you should talk with your physician about its use and the risks of using the drug.
Be sure your doctor knows all the other medications your child has been taking. Include any over the counter and homeopathic therapies you may be using.
Vincristine may reduce immunity to infections. No immunizations should be given while on vincrsitne. Vincristine may lower your body’s resistance to infection and increase the chances of getting the disease the immunization is designed to protect you from.
It is very important that your doctor know if there has been an exposure to chickenpox. Siblings should be vaccinated against chickenpox or have had chickenpox prior to the start of vincristine.
Others living in the household should not take oral polio vaccine while vincristine therapy is in use. If the vaccine has already been given do not allow the vincristine patient to get close to this person. Keep the child away from anyone that is sick.
Notify your doctor if:
The patient has been exposed to chickenpox.
The patient has been exposed to someone that has recently had oral polio vaccine. (live vaccine)
Blistering in the mouth
severe abdominal or muscle cramping
difficulty walking/sitting/ standing
change in bowel movments for more then 2 days
swelling in feet and hands
redness, pain or swellling at injection site.
The most common complication of vincristine therapy is abdominal pain, constipation, elevated bilirubin and jaw pain. Notify your physician if there are any concerns. The intravenous catheter that has been inserted into the vein is designed to protect the patient from complications due to the administration of vincristine. If vincristine accidentally comes in contact with the skin it may damage the tissue and cause scarring. Notify your doctor if there is any redness, pain or swelling at the catheter site.
Dr. Denise Adams, Cincinnati Children’s Hospital, Cincinatti, OH 2007
NOVA PROVIDES THIS INFORMATION TO FAMILIES AS A RESOURCE. IT IS NOT INTENDED TO ENGAGE IN THE PRACTICE OF MEDICINE OR TO REPLACE THE PHYSICIAN. NOVA DOES NOT CLAIM TO HAVE MEDICAL KNOWLEDGE. NOVA DOES NOT ENDORSE ANY PARTICULAR PHYSICIAN, TREATING FACILITY OR TREATMENT PROTOCAL. IN ALL CASES NOVA AND ITS BOARD OF DIRECTORS RECOMMENDS THAT YOU SEEK THE OPINION OF A PHYSICIAN EXPERIENCED IN THE MANAGEMENT OF HEMANGIOMAS AND VASCULAR MALFORMATIONS.
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