Objective: The authors describe the use of interferon-alpha-2a (IFN-α- 2a) in the treatment of complex hemangiomas and review the role of interferon (IFN) in this example of an angiogenic disease. Summary Background Data: Hemangiomas are the most frequent tumors of infants and children. They grow rapidly for 6 to 8 months and then resolve over a period of years. Approximately 5% produce life-, sight-, or limb-threatening complications, with mortality rates between 20% and 50%. Aggressive therapy with steroids, arterial ligation or embolization, or surgery has been used in these situations with variable results and high morbidity. Recently, IFN-α was found to be effective treatment in these complex hemangiomas. Methods: Four infants and one child were treated with IFN-α-2a at an initial subcutaneous dose of 1 million units/m2/day and a sustained dose of 3 million units/m2/day for 5 to 11 months. Appropriate laboratory values were monitored and adverse reactions and ultimate response to therapy were recorded. Results: Two patients experienced minor complications that were managed easily. Three patients had total or near-total regression of the hemangioma, one had partial (50%) regression, and one had stabilization but no regression after an average of 7.1 months of IFN therapy. Conclusion: Interferon-α inhibits angiogenesis and endothelial cell migration and proliferation in vitro. The patients in this study add to the growing number who have benefited from IFN therapy. As such, IFN-α should be considered as a first-line agent in treating complex hemangiomas of infants and children.
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