Acute myeloid leukaemia presenting as retinal vein occlusion and eyelid swelling

Cheung, Chui Ming Gemmy; Tsaloumas, M D

doi:10.1038/sj.eye.6700058

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…In conclusion, in our series of consecutive patients, more than half thrombotic events occurred as presenting manifestation before starting any treatment, giving further evidence in the absence of any publication bias that in leukemic patients vascular occlusion can constitute a complication potentially fatal independently of chemotherapy or supportive measures [45–50]. In particular, treatment seems to constitute a relatively weak additional triggering factor in the APL patients and in AML patients, in comparison with the time of the first clinical presentation.…”

Section: Discussionmentioning

confidence: 56%

The risk of thrombosis in patients with acute leukemia: occurrence of thrombosis at diagnosis and during treatment

Stefano¹,

Sorà²,

Rossi³

et al. 2005

Journal of Thrombosis and Haemostasis

219

165

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Summary. Background: Thromboembolism can occur during acute leukemia, especially acute lymphoid leukemia (ALL) treated with l‐asparaginase. Yet, most reports are anecdotical and scarce data are available on the risk of thrombosis in acute myeloid leukemia (AML). Objectives: To evaluate the risk of thrombosis in patients with acute leukemia. Patients and methods: Three‐hundred and seventy‐nine consecutive adult patients with newly diagnosed acute leukemia were recruited in an observational cohort study conducted from January 1994 to December 2003. Diagnosis was ALL in 69 patients, acute promyelocytic leukemia (APL; FAB subtype M3) in 31, and non‐M3 AML in 279. All first or recurrent symptomatic thromboembolic events objectively diagnosed were recorded. Results: Twenty‐four patients of the overall 379 (6.3%; 95% CI 4.1%–9.2%) had a first thrombosis, venous in 80% of the cases and arterial in 20%. At diagnosis, thrombosis was a presenting manifestation in 13 cases (3.4% of the whole cohort): 1.4% in ALL, 9.6% in APL, and 3.2% in non‐M3 AML patients. Follow‐up was carried out on 343 patients without thrombosis at diagnosis and further 11 thrombotic events (3.2%) were recorded. At 6 months from diagnosis, the cumulative incidence of thrombosis was 10.6% in ALL, 8.4% in APL, and 1.7% in non‐M3 AML patients. The patients who received l‐asparaginase had a 4.9‐fold increased risk of thrombosis in comparison with those who did not (95% CI 1.5–16.0). The fatality rate due to thrombosis was 0.8%. Conclusions: In patients with acute leukemia, the risk of thrombosis is not negligible. Thombosis can be a presenting symptom at diagnosis in a significant portion of cases with APL (9.6%) and non‐M3 AML (3.2%); a similar rate of thrombosis can occur during the subsequent course of the disease. The incidence of symptomatic thrombosis at diagnosis is relatively low in ALL patients (1.4%), but is significantly increased by further treatment up to 10.6%. Strategies of antithrombotic prophylaxis should be investigated in this setting.

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Section: Discussionmentioning

confidence: 56%

The risk of thrombosis in patients with acute leukemia: occurrence of thrombosis at diagnosis and during treatment

Stefano¹,

Sorà²,

Rossi³

et al. 2005

Journal of Thrombosis and Haemostasis

219

165

View full text Add to dashboard Cite

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“…Only 10%-15% of cases are reported to occur in patients below 40 years of age [2]. Given the rare occurrence of simultaneous bilateral CRVO in a previously healthy patient, further testing was prompted to assess for common causes for serum hyperviscosity, such as Waldenstrom's macroglobulinemia, hyperhomocysteinemia, multiple myeloma, acute myeloid leukemia (AML), polycythemia, and chronic myeloid leukemia (CML), revealing our patient's underlying oncologic disease process, ALL [3][4][5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Rare Presentation of Bilateral Central Retinal Vein Occlusion and Leukemic Retinopathy in a Young Adult Diagnosed with T-cell Acute Lymphoblastic Leukemia

Uhr¹,

Thau²,

Chung³

et al. 2020

Cureus

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Simultaneous bilateral central retinal vein occlusion (CRVO) is a rare presentation that warrants consideration of an underlying hyperviscosity state. Increased serum viscosity can lead to the hematologic emergency of leukostasis with resultant vascular obstruction and hypoxic tissue damage. The following case demonstrates the first case of bilateral CRVO in a young adult secondary to acute lymphoblastic leukemia (ALL). A 23-year-old female presented to the emergency department (ED) with two days of worsening bilateral blurry vision and bitemporal headache. Her ocular exam was significant for bilateral intraretinal hemorrhages consistent with CRVO with chest radiograph demonstrating widened mediastinum with perihilar lymphadenopathy and serologic testing revealing ALL with blast crisis. The patient was subsequently admitted to the oncology service for induction chemotherapy. Patients with new headache and bilateral vision changes should prompt a thorough neurological and ophthalmologic exam to assess for underlying systemic pathologies. Concurrent bilateral CRVO is a rare but specific finding for systemic hyperviscosity syndrome, blood dyscrasia, polycythemia, or other serious illness. Early recognition and treatment of the underlying condition can prevent further vision loss and overall morbidity and mortality.

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“…After diabetes mellitus, CRVO is the second most frequent disease causing visual loss. (The Central Vein Occlusion Study Group, 1997) The causes of CRVO are hypertension, cardiovascular disease, cerebrovascular disease, arteriosclerosis, diabetes mellitus, systemic lupus erythematosus, antiphospholipid antibody syndrome, dysproteinemias, hyperhomocysteinemia, leukaemia and lymphoma with thrombocytopenia (Williamson, 1997;Cheung and Tsaloumas, 2002). CRVO commonly affects patients older than 65 years.…”

Section: Discussionmentioning

confidence: 99%

“…Various risks have been identifi ed, including hypertension, hyperlipidemia, diabetes mellitus and hyperviscosity syndrome caused by leukaemia or lymphoma. (Williamson, 1997;Cheung and Tsaloumas, 2002) CRVO commonly affects patients older than 65 years. Bilateral involvement can be seen in 7.7% to 19% of all patients with CRVO (Hayreh, 2003).…”

Section: Introductionmentioning

confidence: 99%

Bilateral central retinal vein occlusion in non-Hodgkin lymphoma and

Cömert¹,

Süllü²

2012

jecm

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Acute myeloid leukaemia presenting as retinal vein occlusion and eyelid swelling

Cited by 3 publications

References 10 publications

The risk of thrombosis in patients with acute leukemia: occurrence of thrombosis at diagnosis and during treatment

The risk of thrombosis in patients with acute leukemia: occurrence of thrombosis at diagnosis and during treatment

Rare Presentation of Bilateral Central Retinal Vein Occlusion and Leukemic Retinopathy in a Young Adult Diagnosed with T-cell Acute Lymphoblastic Leukemia

Bilateral central retinal vein occlusion in non-Hodgkin lymphoma and

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