The Clinical Efficacy Of Oral Propranolol Treatment Of Infantile Haemangiomas And Factors Associated With The Relapse Of The Disease

Background:Infantile haemangioma (IHs) is the most common benign vascular tumor in infantile periods. It is characterized by the rapid growth of endothelial cells and a slow spontaneous involution following that. Propranolol is the first line therapy of infantile haemangioma. However, the clinical use of oral propranolol still faces great challenge, which contain the problem of relapse of IHs after the treatment cessation. Few reports mentioned the recurrence of IHs, however, there is a lack of understanding the risks associated with the rebound.Objective:We conducted a prospective study to investigate the clinical efficacy of oral propranolol in the treatment of infantile hemangiomas and to analyze the factors associated with the risks of relapse of the disease.Methods:43 infants with IH, who were seen between 1 June 2014 and 31 October 2014 at Shandong University Qilu Hospital, were included in the study. Oral propranolol was administered and vital signs of the patient was monitored respectively. The initial dose of propranolol is 1-1.5mg/kg/d, twice daily. The localization, type and distribution of IH and the changes of color, size and softness of IH were systematically recorded for each patient. After discharge the patients were followed up by out-patient review.Results:In total 43 children were included, of whom llpatients were boys and 32 were girls (male:female ratio 1:3),7 had a segmental IH (16%) and 12 (28%) had a deeper component (subcutaneous infantile hemangioma or mixed infantile hemangioma).39 children had finally finished their whole treatments, of whom 36 had not relapsed and 3 had relapsed. Only IHs with a deep component (subcutaneous infantile hemangioma or mixed infantile hemangioma) were independently associated with relapse.Conclusions:Our study shows infantile hemangiomas with a deeper component (subcutaneous infantile hemangioma or mixed infantile hemangioma), are more at risk of relapse and should thus indicate closer follow-up after treatment interruption, and/or long treatment.