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SIROLIMUS EFFICACY IN THE TREATMENT OF CRITICALLY- ILL INFANTS WITH CHYLOUS EFFUSIONS
  • +3
  • Shreya Agarwal,
  • Berkley Anderson ,
  • Priya Mahajan,
  • Caraciolo Fernandes,
  • Judith Margolin,
  • Ionela Iacobas
Shreya Agarwal
Texas Children's Hospital
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Berkley Anderson
Texas Children's Hospital
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Priya Mahajan
Baylor College of Medicine
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Caraciolo Fernandes
Texas Children's Hospital
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Judith Margolin
Baylor College of Medicine
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Ionela Iacobas
Baylor College of Medicine
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Abstract

Background: While rare in children, chylothorax is a significant cause of respiratory morbidity and can lead to malnutrition and immunodeficiency. Historically, the traditional pharmacological treatment has been octreotide. There are several treatments that have been utilized in the past few years including sirolimus, however data regarding their efficacy and outcomes is limited. Furthermore, sirolimus has proven efficacy in complex vascular malformations, and hence, its utility/efficacy in pediatric chylous effusions warrants further investigation. Methods: In this retrospective study at Texas Children’s Hospital, data were extracted for all patients with chylothorax who were treated with sirolimus between 2009 and 2020. Details regarding underlying diagnosis, co-morbidities and number of days from sirolimus initiation to resolution of effusion were collected. Descriptive statistics were used to analyze the study cohort. Results: Initially a total of twelve infants were identified. Among them, seven patients had complete data and were included in the study. The mean duration of sirolimus treatment needed for chest tube removal was 16 days, with a median of 19 days and range of 7- 22 days. Chest tube output corresponded with sirolimus serum trough levels and trended down prior to chest tube removal. Conclusion: With close monitoring, sirolimus is a safe and effective therapy for pediatric lymphatic effusions even in critically-ill infants. The study also demonstrates shorter duration of chest tube requirement after initiation of sirolimus compared to previous studies. Our conclusion is based on a small case series due to the rare incidence of the condition.
07 Sep 2021Submission Checks Completed
07 Sep 2021Assigned to Editor
07 Sep 2021Submitted to Pediatric Blood & Cancer
11 Sep 2021Reviewer(s) Assigned
03 Oct 2021Review(s) Completed, Editorial Evaluation Pending
05 Oct 2021Editorial Decision: Revise Minor
01 Nov 2021Submission Checks Completed
01 Nov 2021Assigned to Editor
01 Nov 20211st Revision Received
06 Nov 2021Reviewer(s) Assigned
11 Nov 2021Review(s) Completed, Editorial Evaluation Pending
15 Nov 2021Editorial Decision: Accept