Retinitis from cytomegalovirus during maintenance treatment for acute lymphoblastic leukemia

Kobayashi, Ryōji; Takanashi, Kuniko; Suzuki, Daisuke; Nasu, Takashi; Uetake, Kimiaki; Matsumoto, Yoshinori

doi:10.1111/j.1442-200x.2011.03429.x

Cited by 21 publications

(16 citation statements)

References 9 publications

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“…3 This hypothesis is supported by low ALC, CD4 + T-cell count, and immunoglobulin levels in the maintenance period. 4 All of our 4 patients had low ALC values at the time of diagnosis of CMV disease. It has been shown that although reconstitution of B cells and natural killer cells occurs early, recovery of both T-helper and T-suppressor cells is delayed in pediatric patients with ALL.…”

Section: Discussionmentioning

confidence: 98%

Cytomegalovirus Disease in Children With Acute Lymphoblastic Leukemia in the Nontransplant Setting

Rahbarimanesh

Ehsani

Karahroudi

et al. 2015

Journal of Pediatric Hematology/Oncology

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Cytomegalovirus (CMV) disease in pediatric acute lymphoblastic leukemia in the nontransplant setting is very rare. We report our experience with 4 such cases, and review the literature (n=12). The median age at diagnosis was 10 years and 50% of patients were males. Among the 11 cases with available information at the time of diagnosis, CMV disease occurred during maintenance therapy in 10 patients. Fever was present in 9 cases. CMV disease manifested as retinitis in 6, hepatosplenic disease in 3, pneumonitis in 1, and hemophagocytic lymphohistiocytosis in 1 patient. One patient had both CMV retinitis and CMV-related hemophagocytic lymphohistiocytosis. Four of the 7 patients with retinitis complained of visual disturbance at diagnosis. CMV viremia was present in 10 patients. Three patients had at least 1 relapse and developed permanent visual defects, and 1 patient developed recurrent retinal detachment. In conclusion, prolonged immunosuppression is the major etiology and retinitis is the most common manifestation of CMV disease. As a significant number of patients with retinitis are asymptomatic, early diagnosis and treatment is important to prevent permanent visual loss.

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Section: Discussionmentioning

confidence: 98%

Cytomegalovirus Disease in Children With Acute Lymphoblastic Leukemia in the Nontransplant Setting

Rahbarimanesh

Ehsani

Karahroudi

et al. 2015

Journal of Pediatric Hematology/Oncology

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“…CMVR is more rarely in patients with ALL who did not receive hematopoietic stem cell transplantations (HSCT) [6]. However, CMVR is also quite rare in patients undergoing maintenance phase therapy (MPT) of ALL [7]. Herein, we report a case of bilateral CMVR in an ALL child in MPT who was not treated with autologous or allogenic HSCT before.…”

Section: Introductionmentioning

confidence: 99%

Cytomegalovirus Retinitis in an ALL Child during Maintenance Therapy Treated Successfully with Intravenous Ganciclovir

Çeliker

Karaaslan

Kadayıfçı

et al. 2014

Case Reports in Ophthalmological Medicine

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Purpose. In here we described cytomegalovirus retinitis (CMVR) in 12-year-old male patient with acute lymphoblastic leukemia (ALL) who was on maintenance phase therapy. Methods. He was referred to our clinic for seeing of spots with the right eye for 3 days. At presentation, his best corrected visual acuity was 20/20 in the right eye and 20/20 in the left eye. Slit-lamp biomicroscopic examination of the anterior chamber of the left eye was within normal limits, whereas we observed 3+ anterior chamber cellular reaction in the right eye. On retinal examination, we found active retinitis lesions (cream-colored lesions associated with hemorrhages) and perivascular cuffing in the retinal periphery in the right eye. Left eye was normal. Results. On the basis of clinical picture, we made the diagnosis of CMVR in the right eye. Vitreous aspiration was performed and 23096 copies/mL of CMV DNA was detected by polymerase chain reaction (PCR) technique. The patient was successfully treated with intravenous ganciclovir for two weeks and discharged with oral valganciclovir prophylaxis. Conclusion. CMVR should be in mind in children with ALL on maintenance phase therapy even in those without hematopoietic stem cell transplantation. These patients can be treated successfully by intravenous ganciclovir alone.

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“…However, CMV retinitis is diagnosed by the presence of characteristic lesions on fundoscopy in immuno-compromised patients by an experienced ophthalmologist [1]. CMV retinitis is very rare in acute lymphoblastic leukemia especially during the maintenance therapy [2,10,11]. There are no studies which have looked at this entity in the past and currently there are only case reports that have been published reporting CMV retinitis after high dose chemotherapy especially during the induction phase [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

An Interesting Case of CMV Retinitis in a Case of ALL on Maintenance Therapy

Singh

Dayama

Maiwall

et al. 2013

Indian J Hematol Blood Transfus

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Retinitis from cytomegalovirus during maintenance treatment for acute lymphoblastic leukemia

Cited by 21 publications

References 9 publications

Cytomegalovirus Disease in Children With Acute Lymphoblastic Leukemia in the Nontransplant Setting

Cytomegalovirus Disease in Children With Acute Lymphoblastic Leukemia in the Nontransplant Setting

Cytomegalovirus Retinitis in an ALL Child during Maintenance Therapy Treated Successfully with Intravenous Ganciclovir

An Interesting Case of CMV Retinitis in a Case of ALL on Maintenance Therapy

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