Treatment of kaposiform hemangioendothelioma and tufted angioma

Int J Cancer. 2016 Oct 1;139(7):1658-66. doi: 10.1002/ijc.30216. Epub 2016 Jun 28.


This meta-analysis was to evaluate the efficacy of current treatment modalities for kaposiform hemangioendothelioma and tufted angioma. A systematic review was performed using PubMed (Medline), Web of Science and Embase for clinical studies. The outcome was measured by pooled response rate with 95% confidence intervals (CIs), together with heterogeneity, subgroup analysis, sensitivity analysis and publication bias. Fifteen studies with 244 participants were included in this analysis. Vincristine therapy exhibited a relatively higher response rate (0.72; 95%CI, 0.64-0.79) compared with other therapies including systemic corticosteroid (0.27; 95%CI, 0.17-0.36), interferon (0.36; 95%CI, 0.24-0.48), radiotherapy (0.49; 95%CI, 0.26-0.73), embolization (0.66; 95%CI, 0.48-0.83), aspirin/ticlopidine (0.42; 95%CI, 0.06-0.78) and sirolimus (0.57; 95%CI, 0.00-0.10), in treating KHE/TA. Subgroup analysis indicated that the efficacy of systemic corticosteroids therapy was age-related. The pooled response rate was 0.15 (95%CI, 0.08-0.23) for participants 3.5 months of age and older compared with 0.35 (95% CI, 0.26-0.44) for participants less than 3.5 months. Regarding side effects, systemic corticosteroids treatment was 0.32 (95%CI, 0.15-0.50), vincristine modality was 0.16 (95%CI, 0.08-0.24) and interferon therapy was 0.28 (95%CI, 0.13-0.43). In conclusion, as one of the first reviews evaluating the effect of common therapies in the treatment of KHE/TA, our meta-analysis displayed that vincristine was more effective. Thus, vincristine was the most effective, providing evidence supporting the use of vincristine as a first-line therapy for KHE/TA.

Keywords: Kasabach-Merritt phenomenon; kaposiform hemangioendothelioma; treatment; tufted angioma.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Clinical Trials as Topic
  • Hemangioendothelioma / drug therapy
  • Hemangioendothelioma / therapy*
  • Hemangioma / drug therapy
  • Hemangioma / therapy*
  • Humans
  • Kasabach-Merritt Syndrome / drug therapy
  • Kasabach-Merritt Syndrome / therapy*
  • Randomized Controlled Trials as Topic
  • Sarcoma, Kaposi / drug therapy
  • Sarcoma, Kaposi / therapy*
  • Skin Neoplasms / drug therapy
  • Skin Neoplasms / therapy*
  • Vincristine / therapeutic use


  • Vincristine

Supplementary concepts

  • Kaposiform Hemangioendothelioma
  • Tufted angioma