May 2025, Volume 3, Issue 5

Author

Vivek Viswanathan

Abstract

Background: Lymphangiomas are rare congenital malformations that and pose a specific challenge in the pediatric age group and require effective therapeutic intervention. In our systematic review we look at how bleomycin therapy for lymphangiomas has evolved across the five decades from (1977-2024). Methods: We conducted a systematic literature review of 127 studies, via a comprehensive search of a plethora of databases including PubMed/MEDLINE, Embase, and Cochrane Library. This analysis of studies allowed us to chart the gradual transition from surgery being the mainstay of treatment to bleomycin becoming a preferred treatment modality. Results: Analysis of our observations showed that our current success rates for bleomycin therapy range from 60-88%, with huge age dependent variations in the treatment responses. Protocol refinement has led to a significant improvement in standardization of therapy. Optimal concentration of 1 IU/mL with maximum cumulative therapy dose of 15 IU/kg are the established standards now. Conclusions: Recent advances in molecular pathophysiology have yielded promising results from combination therapy approaches which suggests new avenues for more efficacious treatment methods. We propose structured evidence based recommendations which emphasise the standardisation of protocols whilst incorporating personalized therapy based on lesion morphology and patient characteristics.