#1 Ranked Children’s Hospital by U.S. News & World Report
MyPatients provides referring primary care providers with secure access to their patients’ information.
Boston Children's has launched the world's 1st program dedicated to offering hand transplants to children who qualify.
Innovation insider is a semi-monthly e-newsletter analyzes innovations at Boston Children’s, other academic medical centers and from industry.
Read the latest blog by a Boston Children's doctor, clinician or staff member.
There are many ways you can help children and their families get the care they need.
The treatment goals with kaposiform hemangioendothelioma (KHE) are to relieve symptoms, reverse KMP if it is present, and shrink the tumor. Ideally, thorough treatment will prevent problems later in life, including tumor recurrence. Some tumors shrink and even become invisible with therapy.
KHE treatment takes an interdisciplinary, team-based approach. Often the team is led by a hematologist/oncologist. Some or all of the following specialists may be involved as well:
Your care team will outline the benefits of all the KHE treatment options listed below:
Observation — For superficial tumors without low platelets, your child’s doctor may want to simply observe the tumor for a period of time. This allows your child’s care team to determine how the tumor is behaving.
Some mild KHE tumors go away without treatment, so if we observe the tumor for a few months and see that it’s shrinking, we probably won’t recommend any treatment.
However, if a KHE tumor grows, we can immediately step in with aggressive treatment to stabilize, shrink or remove it.
Steroids — In mild cases, your doctor may recommend treating the tumor with oral steroids first. While only about 12 percent of KHE tumors respond to steroids, oral steroids are safe and may help other treatments work better.
Some patients with superficial lesions may be treated with medicated creams or lotions, including creams containing steroids or timolol. It is unclear whether these ointments offer benefit, however, as such lesions often improve in time without therapy.
Other medications — Some of the commonly recommended medications for KHE are categorized as “chemotherapy,” meaning they may also be used for cancer treatment. But individual medications on this list do not lead to all the side effects many people associate with chemotherapy. Your doctor will explain the common and uncommon side effects of the particular medications relevant to your child’s case. Two drugs that may be considered are:
In very aggressive cases, or in situations where a tumor doesn’t respond to any of these therapies, your doctor may consider:
Very rarely. KHE will quickly trap new platelets, causing the tumor to quickly swell and possibly become painful. However, platelet transfusions can be given to stop significant bleeding or prevent bleeding during necessary procedures.
It’s important to treat the tumor, not the platelet count. We focus on shrinking the tumor, understanding that a child’s platelet count will go up as the tumor shrinks, because it’s not trapping as many platelets.
Many patients have an excellent long-term outlook through successful KHE treatment. KHE is a very rare tumor and we are actively researching how to predict long-term outcomes from this lesion. In general, you child's prognosis depends on:
It’s important to see a specialist quickly when KHE is suspected to allow early discussions about treatment. Specialists can then attempt to shrink the tumor before it
affects muscles or other tissues nearby. Early treatment could also help reduce long-term complications by preventing further growth.
There is some evidence that these tumors can recur, especially if initial treatment is incomplete. However, if your child’s tumor does recur, we have good success treating it again, reducing its size and stabilizing your child’s platelet count.
Kaposiform hemangioendothelioma: Reviewed by Cameron C. Trenor III, MD, © Boston Children's Hospital, 2016
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”