Open Access

Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports)

  • Authors:
    • Cătălin Cîrstoveanu
    • Ana Mihaela Bizubac
    • Cristina Mustea
    • Ștefan Manolache
    • Alexandra Istrate‑Bârzan
    • Doinița Sfrijan
    • Veronica Marcu
    • Dan-Alexandru Iozsa
    • Radu-Iulian Spătaru
  • View Affiliations

  • Published online on: August 2, 2021     https://doi.org/10.3892/etm.2021.10531
  • Article Number: 1097
  • Copyright: © Cîrstoveanu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

We present a series of four newborns diagnosed with complicated congenital vascular anomalies, with different localization: Congenital lymphatic malformation (CLM) on the left hemithorax extending on the left upper limb; congenital hepatic hemangioma (CHH) with important complications in the first 7 weeks of life; Kaposiform hemangioendothelioma (KHE) of the left lower limb complicated with Kasabach Merritt phenomenon (KMM) and most probable diffuse capillary malformation with overgrowth (DCMO). All patients were treated with combined antiproliferative therapy with sirolimus and propranolol. The initial dose of sirolimus was 0.45‑0.5 mg/m2 with doses adjusted according to plasmatic levels. Therapeutic intervals of sirolimus were considered at plasmatic levels of 7‑12 ng/ml. Our aim was to use the lowest therapeutic dose in order to avoid possible side effects. Propranolol was initiated in doses of 0.5‑1.0 mg/kg/day and was increased up to 3.0 mg/kg/day depending on tolerability. Following two months, every patient showed a marked reduction in the size of the mass, improvement in overall appearance or even calcification in the liver vascular tumor. No patient showed life threatening side effects to the treatment. Hypertriglyceridemia was the only side effect noted in all patients. This is in accordance with several international studies, which try to demonstrate the importance of sirolimus in neonatal vascular malformations in monotherapy or combined with different drugs.
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October-2021
Volume 22 Issue 4

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Cîrstoveanu C, Bizubac AM, Mustea C, Manolache Ș, Istrate‑Bârzan A, Sfrijan D, Marcu V, Iozsa D and Spătaru R: Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports). Exp Ther Med 22: 1097, 2021.
APA
Cîrstoveanu, C., Bizubac, A.M., Mustea, C., Manolache, Ș., Istrate‑Bârzan, A., Sfrijan, D. ... Spătaru, R. (2021). Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports). Experimental and Therapeutic Medicine, 22, 1097. https://doi.org/10.3892/etm.2021.10531
MLA
Cîrstoveanu, C., Bizubac, A. M., Mustea, C., Manolache, Ș., Istrate‑Bârzan, A., Sfrijan, D., Marcu, V., Iozsa, D., Spătaru, R."Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports)". Experimental and Therapeutic Medicine 22.4 (2021): 1097.
Chicago
Cîrstoveanu, C., Bizubac, A. M., Mustea, C., Manolache, Ș., Istrate‑Bârzan, A., Sfrijan, D., Marcu, V., Iozsa, D., Spătaru, R."Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports)". Experimental and Therapeutic Medicine 22, no. 4 (2021): 1097. https://doi.org/10.3892/etm.2021.10531