THREE YEAR OUTCOME OF BLEOMYCIN SCLEROTHERAPY TREATMENT OF VASCULAR ANOMALIES: CLEVELAND VASCULAR MALFORMATION GROUP RESULTS

Introduction and aims Intralesional bleomycin sclerotherapy has been offered to 63 of 238 patients presenting with haemangiomas and vascular malformations in our centre over the last three years. Methods Clinical response, administered dose, amount of sessions and complications were recorded. 42 of the 66 patients have completed their treatment thus far. Respiratory surveillance is provided by an adult and paediatric pulomonologist utilising the locally agreed Cleveland malformation surveillance protocol. Results Thirteen children and 29 adults completed treatment with a mean of 3.4 sclerotherapy sessions. 17% of children treated were under the age of 1. Treatment lasted for an average of 88 days. 43% of patients received prior treatment other than bleomycin. The following pathologies were treated: haemangioma 10, venous malformation 26, lymphatic malformation 4, capillary malformation 1, AVM 1. Complete resolution occurred in 66%, with an overall response rate of 98%. Skin ulceration occurred in 1 patient, minor blistering in 5, infection 1, swelling 1, headache 1, bruising, skin rash 1 and skin pigmentation occurred in 3 patients. The maximum administered dose was 3 mg/kg. Conclusion Predictable results were obtained with a high success rate. No systemic or pulmonary complications occurred. Secondary treatment, apart from bleomycin sclerotherapy was only needed in two patients with partially resoluted hemangiomas.