[Medical treatment of children with hemangiomas and its limitations]

Children with disfiguring and/or life-threatening hemangiomas need medical treatment. Initial therapy comprises the oral administration of prednisolone in a dosage between 2-3 mg/kg/day. In cases of insufficient response to prednisolone the therapy may be extended by additional subcutaneous administration of interferon-alpha in a dosage between 1-3 million U/m(2)/day. However, due to the possible serious side effects of interferon-alpha, such as irreversible spastic diplegia, this therapy must be accompanied by close and meticulous neurological examinations of the treated children. The chemotherapeutic substance vincristine has nowadays become an alternative to interferon-alpha for life-threatening hemangiomas. The substance proved effective in a dosage of 0.05 mg/kg for children less than 10 kg and 1.5 mg/kg for children more than 10 kg given weekly strictly intravenously. In worst-case scenarios, a successful disease control has been achieved by intravenous administration of cyclophosphamide in a dosage of 10 mg/kg/day given on 3 consecutive days. Medical treatment of children with life-threatening hemangiomas still remains challenging for all involved persons and should always be performed in specialised centres.