Optic nerve head infiltration in acute leukemia in children: An indication for emergency optic nerve radiation therapy

Kaikov, Yigal

doi:10.1002/(sici)1096-911x(199602)26:2<101::aid-mpo6>3.0.co;2-p

Cited by 47 publications

(19 citation statements)

References 12 publications

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“…To test the hypothesis that increased expression of IL-15 will be associated with CNS leukemia, we used the T-cell leukemia/ lymphoma model described by Hochman et al 41 advanced CNS leukemia. [42][43][44] Lymphoblasts isolated from the eye continue to secrete the IL-15 protein ( Figure 1D).…”

Section: Discussionmentioning

confidence: 99%

Central nervous system acute lymphoblastic leukemia: role of natural killer cells

Frishman-Levy

Shemesh

Bar-Sinai

et al. 2015

Blood

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Key Points• Increased IL-15 expression in leukemic lymphoblasts is associated with activation of NK cells.• The CNS may be an immunologic sanctuary protecting lymphoblasts from NK-cell activity.Central nervous system acute lymphoblastic leukemia (CNS-ALL) is a major clinical problem. Prophylactic therapy is neurotoxic, and a third of the relapses involve the CNS. Analysis of bone marrow (BM) diagnostic samples derived from children with subsequent CNS-ALL revealed a significantly high expression of the NKG2D and NKp44 receptors. We suggest that the CNS may be an immunologic sanctuary protected from NK-cell activity. CNS prophylactic therapy may thus be needed with emerging NK cell-based therapies against hematopoietic malignancies. (Blood. 2015;125(22):3420-3431)

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Section: Discussionmentioning

confidence: 99%

Central nervous system acute lymphoblastic leukemia: role of natural killer cells

Frishman-Levy

Shemesh

Bar-Sinai

et al. 2015

Blood

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“…In leukemic retinopathy, leukemic infiltrations and hemorrhage can be found in the retinal area by funduscopic examination 20 . Although the prognosis for restoration of vision is poor, visual recovery after emergent radiotherapy has been reported 21 . In our patient, unlike the patient reported by Nishi et al 7 , a typical leukemic retinopathy with cns relapse was found, together with hypopituitar ism.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Hypopituitarism and Leukemic Retinopathy in a Child with B-Precursor Acute Lymphoblastic Leukemia and Isolated Central Nervous System Relapse

Lin

et al. 2016

Current Oncology

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Hypopituitarism in leukemia is very rare. In addition, central nervous system (cns) relapse and leukemic retino pathy in childhood acute lymphoblastic leukemia (all) have declined with the use of modern systemic chemo therapy that includes cns prophylaxis. Here, we report the case of a 4yearold girl who received chemotherapy and intrathecal therapy without cns radiation after a diagnosis of Bprecursor all without cns involvement. Three months after chemotherapy completion, she presented with lowerextremity weakness and was diagnosed with an isolated cns relapse. Concurrent hypopituitarism and leukemic retinopathy were also found. After receiving craniospinal radiotherapy and systemic chemotherapy, her retinopathy and vision improved. She is now in com plete remission, and she is still on chemotherapy according to the guideline from the Pediatric Oncology Group. Although rare, hypopituitarism and leukemic retinopathy should be taken into consideration in patients with cns involvement by leukemia.

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“…Retinal haemorrhage is the most common finding in leukaemic ophthalmopathy [4]. Other causes of vision loss in patients with leukaemia include vincristine-induced optic atrophy, cortical blindness and radiation retinopathy [5]. In patients with papilloedema, meticulous scrutiny of the CNS is always warranted because leukaemic infiltration of other regions of the brain plays a pivotal role in patient management [1].…”

Section: Discussionmentioning

confidence: 99%

Rapid vision loss in a 15-year-old boy

Mittal

Ko²,

Chang³

2011

BJR

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A 15-year-old boy with a recent diagnosis of T-cell acute lymphoblastic leukaemia (ALL) and a history of factor V Leiden heterozygosity presented with a sudden onset of bilateral vision loss over a 24 h period. 2 weeks prior to presentation he received pegaspargase chemotherapy. During the week preceding admission he had noted mild blurred vision and complained of retro-orbital headaches. Ophthalmic examination revealed visual acuity of 20/800 in the right eye and minimal light perception in the left eye. He had sluggish pupillary reactivity to light with a left relative afferent pupillary defect. Dilated fundoscopic examination demonstrated bilateral florid optic disc swelling with peripapillary and dot-blot haemorrhages in the periphery, and macular oedema of the left eye. Neurological examination demonstrated mild left peripheral seventh nerve palsy.Multiplanar and multisequence MRI of the orbits, face and neck were obtained before and after administration of 20 cc iv contrast (Figures 1-4).

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Optic nerve head infiltration in acute leukemia in children: An indication for emergency optic nerve radiation therapy

Cited by 47 publications

References 12 publications

Central nervous system acute lymphoblastic leukemia: role of natural killer cells

Central nervous system acute lymphoblastic leukemia: role of natural killer cells

Concurrent Hypopituitarism and Leukemic Retinopathy in a Child with B-Precursor Acute Lymphoblastic Leukemia and Isolated Central Nervous System Relapse

Rapid vision loss in a 15-year-old boy

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