How to use bleomycin A5 for infantile maxillofacial haemangiomas: Clinical evaluation of 82 consecutive cases

Objective: Bleomycin AS has been reported effective for infantile haemangioma (IH), but the usage and complications were described a little. We have used bleomycin A5 to treat maxillofacial IHs for 15 years. This paper describes the procedures to use bleomycin A5 and avoid its complications based on our clinical practices. Methods: Bleomycin A5 (8 mg, powder) was mixed with 2% lidocaine (3 ml) and dexamethasone (1 ml, 5 mg), the mixture concentration is 2 mg/ml (bleomycin A5). The drug was given by multiple intralesional injections, with the dosage calculated according to the age of the patient and size of the lesion. Cautions were paid to the drug dosage and concentration, as well as the depth of injection. The patients were also given oral prednisone (2-5 mg/kg every other day) during proliferating stage. Results: After treatment with bleomycin A5 in appropriate quantity and concentration, injecting depth, all haemangiomas involuted completely, with smaller lesions showing better recovery of skin colour and less scar formation, and no serious side effects happened. Conclusion: Bleomycin A5 is an effective treatment for IHs. Oral prednisone is necessary for patients at proliferating stage. (C) 2010 European Association for Cranio-Maxillo-Facial Surgery.