Safety and Efficacy of Bleomycin Sclerotherapy for Microcystic Lymphatic Malformation

Gulraiz Chaudry, Carlos J. Guevara, Kristy L. Rialon, Cindy Kerr, John B. Mulliken, Arin K. Greene, Steven J. Fishman, Debra Boyer, Ahmad I. Alomari

Research output: Contribution to journalArticlepeer-review

76 Scopus citations


Methods: The medical records and imaging studies of all patients with microcystic or combined LM who underwent percutaneous image-guided sclerotherapy using bleomycin were retrospectively reviewed. Only patients with pre- and postprocedure imaging were included. Thirty-one patients with a mean age of 13.4 years (range 3 months–31 years) were treated. Response was graded as complete (>90 % size reduction), partial (25–90 %), or minimal/no response (<25 %). Pulmonary function tests (PFT) and chest X-rays were performed before the procedure. PFT were repeated at 6 months and 1 year postprocedure. Annual postprocedure chest X-rays were also performed.

Purpose: Sclerotherapy is the mainstay of treatment of macrocystic lymphatic malformation (LM), but the response using traditional sclerosants is much less beneficial in microcystic lesions. Intralesional bleomycin has been reported to be effective in microcystic LM; however, its use is limited by concerns about pulmonary fibrosis. The purpose of this study was to evaluate the safety and efficacy of bleomycin sclerotherapy in microcystic LM.

Results: The malformations were located in the head and neck (n = 27) and trunk (n = 4). The number of procedures ranged from 1 to 4 (mean 1.7). Up to 1 U/kg of bleomycin was injected per session, with a maximum of 15 U. The mean follow-up period was 3.2 years (range 1.5–5 years). There was complete response in 38 % (n = 12), partial response in 58 % (n = 18), and no response in 3 % (n = 1). No complications were identified.

Conclusions: Preliminary indicate that sclerotherapy of microcystic LMs using bleomycin is effective and safe.

Original languageEnglish
Pages (from-to)1476-1481
Number of pages6
JournalCardiovascular and Interventional Radiology
Issue number6
StatePublished - Dec 2014


  • Nonvascular interventions
  • Pediatric
  • Sclerotherapy


Dive into the research topics of 'Safety and Efficacy of Bleomycin Sclerotherapy for Microcystic Lymphatic Malformation'. Together they form a unique fingerprint.

Cite this