This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (20)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Dermatology  • Pediatric Otolaryngology  • Papillomavirus, Human  • Alert me on articles by topic  Social Bookmarking   What's this?

Lee M. Akst, MD; Walter Lee, MD; Christopher Discolo, MD; Daniel Knott, MD; Abbas Younes, MD; Peter J. Koltai, MD

Arch Otolaryngol Head Neck Surg. 2003;129:841-846.

Objective  To evaluate a stepped-dose protocol for intralesional injection of cidofovir in children with recurrent respiratory papillomatosis (RRP).

Design  Prospective, nonrandomized case series.

Setting  Tertiary care children's hospital.

Participants  Eleven children undergoing evaluation for RRP from June 1, 2000, through December 31, 2001.

Intervention  Intralesional injection of cidofovir was performed after microlaryngoscopy and carbon dioxide laser treatment. Patients received 4 monthly injections at a concentration of 5 mg/mL and returned 1 month after the last injection for follow-up. Patients with recurrent or recalcitrant disease then started a series of 4 monthly injections at a concentration of 10 mg/mL.

Outcome Measure  Papilloma stage (0-3) documented at multiple subsites by means of serial microlaryngoscopy. We calculated a severity score by summing the scores at all affected subsites.

Results  The severity score decreased in each of the 11 patients during the course of therapy, from a mean ± SD of 13.7 ± 6.0 at enrollment to 2.1 ± 3.4 at 1-month follow-up. Six patients experienced complete resolution (stage 0) and 4 others had mild disease (stage, 5) after 4 treatments at the 5-mg/mL concentration. Five patients with residual or recurrent RRP subsequently started a series of 4 cidofovir treatments at a concentration of 10 mg/mL, with a mixed response.

Conclusions  Intralesional injection of cidofovir seems to reduce the burden of disease in children with RRP. Patients with persistent or recurrent disease may benefit from an increased cidofovir concentration of 10 mg/mL, although some aggressive papillomatous disease remains refractory to cidofovir treatment.

From the Department of Otolaryngology and Communicative Disorders, The Cleveland Clinic Foundation, Cleveland, Ohio. The authors have no relevant financial interest in this article.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Use of Cidofovir for Treatment of Recurrent Respiratory Papillomatosis
Derkay
Arch Otolaryngol Head Neck Surg 2009;135:198-201.
FULL TEXT  

Recurrent respiratory papillomatosis.
Tasca and Clarke
Arch. Dis. Child. 2006;91:689-691.
ABSTRACT | FULL TEXT  

Intralesional Cidofovir for Pediatric Recurrent Respiratory Papillomatosis
Mandell et al.
Arch Otolaryngol Head Neck Surg 2004;130:1319-1323.
ABSTRACT | FULL TEXT