The Eye as a Sanctuary in Acute Lymphoblastic Leukæmia

Ninane, J.; Taylor, David; Day, Susan H.

doi:10.1016/s0140-6736(80)90999-x

Cited by 76 publications

(32 citation statements)

References 9 publications

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“…Previous reports suggested that intrathecal chemotherapy may not penetrate to the retrobulbar optic nerve in adequate amount to treat overt leukaemia. 3,5,11 Nikaido et al 5 reported five cases of relapsing optic nerve infiltration in patients with acute leukaemia, though complete remission was once achieved after intrathecal chemotherapy in these patients. Nevertheless, intrathecal chemotherapy might be not enough to eradicate all the leukaemic cells in paraneural space of the optic nerve.…”

Section: Discussionmentioning

confidence: 99%

“…5,11 Nikaido et al 5 propose that there could be a barrier between the optic nerve lesions and the remainder of the CNS in the patients with leukaemic infiltration of the optic nerve. The barrier interrupts the smooth flow of CSF, so the cytotoxic drugs cannot reach the affected areas of the optic nerve.…”

Section: Leukaemic Infiltration Of the Optic Nerve Y-c Lin Et Al 548mentioning

confidence: 99%

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Leukaemic infiltration of the optic nerve as the initial manifestation of leukaemic relapse

Lin

Wang

Yen

et al. 2004

Eye

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Section: Discussionmentioning

confidence: 99%

Section: Leukaemic Infiltration Of the Optic Nerve Y-c Lin Et Al 548mentioning

confidence: 99%

Leukaemic infiltration of the optic nerve as the initial manifestation of leukaemic relapse

Lin

Wang

Yen

et al. 2004

Eye

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“…В результате химиотерапии достигается клинико-гематологическая ремиссия, бластные клетки в периферическом кровотоке и в ликворе не опре-деляются. В офтальмологической литературе, в том числе посвящённой наблюдению и лечению пациентов с лейкемической инфильтрацией, глаз-ное яблоко образно сравнивается с «фармаколо-гическим заповедником» [21]. В период химиоте-рапии глаз может оставаться «заповедником» для циркулирующих бластных клеток, что связано с тем, что внутривенные химиопрепараты крайне плохо проникают через гематоофтальмический барьер [21].…”

Section: Discussionunclassified

A case of isolated intraocular recurrence of acute lymphoblastic leukemia

Chistyakova

Шадричев²,

Кузнецова

2017

Ophthalmology Reports

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The development of diagnostic and therapeutic capabilities in hematology contributed to a growth in survival rate in patients with acute leukemia and to the increase in number of different ocular conditions as rare signs of hemoblastosis recurrence and treatment’s side effects. We observed a female patient with extramedullar leukemic ocular damage in acute lymphoblastic leukemia. It is noteworthy that the process of ocular involvement into the underlying disease occurred on the background of complete confirmed hematologic remission. (For citation: Chistyakova NV, Shadrichev FE, Kuznetsova TI. A case of isolated intraocular recurrence of acute lymphoblastic leukemia. Ophthalmology Journal. 2017;10(3):74-84. doi: 10.17816/OV10374-84).

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“…It has been suggested that the eye represents a “sanctuary” site in acute leukemia, harboring leukemic blast cells in the iris, choroid, or optic nerve that are suppressed but not eradicated by chemotherapy [12,13,14]. It has been postulated that harbored leukemic cells multiplying within the retina may impair normal retinal fluid resorption leading eventually to widespread serous retinal detachment [15].…”

Section: Discussionmentioning

confidence: 99%

Rapidly Progressive, Isolated Subretinal Leukemic Relapse: A Case Report

et al. 2017

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Purpose: The aim of this paper is to describe a case of relapsed pediatric acute lymphoblastic leukemia (ALL) presenting as a rapidly progressive subretinal infiltrate, as diagnosed by ultrasound-guided fine needle aspiration (FNA). Methods: We conducted a clinical pathological retrospective chart review. Results: Eleven months after documented remission of T-cell ALL while on maintenance therapy, this 17-year-old patient presented with acute open angle glaucoma in the right eye. B-scan ultrasonography suggested total retinal detachment. Eight weeks later, based on routine cerebrospinal fluid analysis, the patient was diagnosed with central nervous system relapse of T-cell ALL. Repeat B-scan 1 week later showed a new hyperechoic subretinal mass. FNA of the mass confirmed leukemic infiltrate. The involved eye was enucleated, demonstrating leukemic cells throughout the subretinal space, choroid, and the optic nerve. Following hematopoietic stem cell transplant, the patient continues to maintain bone marrow remission 5 months after enucleation without involvement in the opposite eye. Conclusion: Retinal detachment in any patient with a history of leukemia should raise the possibility of relapse and may warrant aspiration/biopsy if other means of diagnosing relapse are inconclusive. Subretinal infiltrate may progress rapidly and prompt diagnosis is paramount to tailoring therapy and preserving vision.

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The Eye as a Sanctuary in Acute Lymphoblastic Leukæmia

Cited by 76 publications

References 9 publications

Leukaemic infiltration of the optic nerve as the initial manifestation of leukaemic relapse

Leukaemic infiltration of the optic nerve as the initial manifestation of leukaemic relapse

A case of isolated intraocular recurrence of acute lymphoblastic leukemia

Rapidly Progressive, Isolated Subretinal Leukemic Relapse: A Case Report

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