Journal of Blood Disorders & Transfusion

Success of Interferon Alpha 2b in Recurrent Metastatic EpithelioidHemangioendothelioma

2^nd International Conference on Hematology & Blood Disorders

September 29-October 01, 2014 DoubleTree by Hilton Baltimore-BWI Airport, USA

Nay T Tun and Mahesh Krishnamurhty

Posters: J Blood Disorders Transf

Abstract:

Epithelioidhemangioendothelioma (EHE) is a variant of epitheloid vascular tumors that originates from the vascular endothelium.EHE was first described by Weiss and Enzinger in 1982, and has been found in skin, lung, pleura, liver, bone, brain, heart, and other organs. The etiology of EHE remains unclear. Genetically, the translocation t(1;3)(p36.3,q25) has been found in two EHE cases.Although EHE is considered an intermediate malignancy between hemagioma and angiosarcoma, the clinical behavior of this vascular tumor is unpredictable. Management of EHE remains a therapeutic challenge due to the extremely low incidence of this vascular tumor, variable disease courses with different responses to surgery, chemotherapy or anti-angiogenic agents. We are presenting the case of a young woman who was diagnosed with metastatic EHE to liver and lung at the age of 26 years old. She was initially treated with Adriamycin without response, and subsequently chemo-embolization of bulky left hepatic disease that was causing intractable abdominal pain and left shoulder pain. Further progressive disease was managed with left lateral segmental hepatectomy, which was combined with aggressive loco-regional management of additional metastatic lesions with cryoablation and radiofrequency ablation. Unfortunately, the tumor relapsed about two years and nine months after this aggressive surgical approach. She then began treatment with interferon alpha 2b for approximately seven years, attaining a complete hepatic clinical remission on PET/CT after the first three years of treatment. She has been off treatment since March 2010, and to-date she remains free of disease with a Karnofsky scale of 100. The patient has therefore had a durable clinical response to interferon alpha 2b for more than ten years, with a complete hepatic clinical response for more than seven and a half years, since May 2006. One of the mechanisms of action for alpha interferon has been shown to be anti-angiogenesis, and it is possible that it is this mechanism of action that has successfully controlled this patient?s aggressive metastatic EHE. Therefore, alpha interferon should be considered as a potential treatment for metastatic or recurrent metastatic EHE, since our patient has had a durable clinical response to alpha interferon for more than a decade since the treatment was initiated.

Biography :

Nay Thi Tun is currently in Residency Training of Internal Medicine Program in Easton Hospital, PA. She has obtained M.B.B.S in Yangon, Myanmar. 3 months of compulsory internship/residency in Myanmar. At present she is a committee member of ?Blood Blank? in Easton Hospital and ?Instiutional Review Board? in Easton Hospital as well as she is an acting as a student coordinator. She has participated in many medical meetings and publishes number of research works.