Title:
Intralesional cidofovir in severe juvenile respiratory papillomatosis
Authors:
Y. Ablanedo-Terrazas , A. Soda-Merhy , M. Hernández-Palestina , C. E. Ormsby and G. Reyes-Terán
Institutions:
C entro de Investigación en Enfermedades Infecciosas, 2Departamento de Otorrinolaringología, Instituto Nacional de Enfermedades Respiratorias, Mexico City.
Keywords:
Cidofovir; recurrent respiratory papillomatosis; larynx; dysplasia
Pages:
197 - 202
Abstract:
Intralesional cidofovir in severe juvenile respiratory papillomatosis. Recurrent respiratory papillomatosis causes significant morbidity among affected children and usually requires frequent surgeries. We present a prospective case series including nine children at a Mexican tertiary referral center. All enrolled patients had severe disease that had required at least four surgical procedures, with a median of 6. Two children had tracheobronchial involvement, one had lung parenchymal disease, and one had a tracheostomy performed during his first surgery. Objective: To assess the efficacy of intralesional cidofovir in lowering the surgery rate. Study Design: Prospective case series. Setting: Tertiary referral center in Mexico City. Methods: Nine Mexican children with severe disease were enrolled. Intralesional cidofovir was applied after surgical debulking at a concentration of 5mg/mL with a four to six week interval. Results: Six of the nine patients had a notable decrease in the rate of surgeries, with three patients remaining disease- free with follow up ranging from 1.8 to 3.3 years. No patient demonstrated laboratory abnormalities. Two patients showed moderate and mild dysplasia on papilloma biopsy distinguished by a lack of epithelial maturation with no mitoses or cellular atypia. Two patients died several months after the last injection. Conclusions: Intralesional cidofovir appears to be effective in the treatment of recurrent respiratory papillomatosis, although further studies are required to determine its safety.
Issue:
Vol. 8, 2012, 3rd trimester


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Intralesional cidofovir in severe juvenile respiratory papillomatosis