Treatment of alarming hemangiomas in infancy: efficacy and safety of interferon alpha.

Alarming hemangiomas, due to their site or repercussions, require pharmacol ogical treatment. Corticosteroid therapy is indicated by first intention. I n the event of failure, inferferon alpha is proposed. Case reports. - Case 1. A five-week-old infant was admitted to hospital for an extensive hemangioma of the left side of the face and neck with necrosi s of the upper lip and ear. Prednisolone (2 mg/kg/day) by intravenous route brought about no improvement. Interferon alpha 2a (3 MU/m(2)/day of Rofero rn(R) by subcutaneous injection) enabled regression of lesions from the six th month of treatment. After II months of treatment, the hemangioma had all but disappeared and interferon therapy was stopped. Repair surgery was pla nned at 24 months of age. Case 2. A one-month-old infant suffered from a he mangioma of the right side of the face with orbital invasion and risk of am blyopia. Prednisone (2 mg/kg/day) by oral route was ineffective. Interferon alpha 2a enabled regression of the hemangioma and the eye opened from the third month of treatment. Interferon therapy was stopped after 14 months. I nitial repair surgery intervention was possible at two years of age. Spasti c paraplegia was diagnosed at 18 months of age. The brain and medullar magn etic resonance imaging was normal. No etiology could explain the neurologic al attack. The possible toxic effect of interferon alpha is discussed. Conclusion. - Interferon alpha is an effective treatment for hemangiomas. I t significantly reduces spontaneous regression time. The uncertainty of lon g-term effects in infants with hemangiomas incites its indication to be lim ited to alarming corticosteroid-resistant forms and necessitates prolonged neurological surveillance. (C) 2000 Editions scientifiques et medicales Els evier SAS.