Faculty Collaboration Database

The optic nerve as the site of initial relapse in childhood acute lymphoblastic leukemia. Cancer 1989 Apr 15;63(8):1616-20

Date

04/15/1989

Pubmed ID

2635874

DOI

10.1002/1097-0142(19890415)63:8<1616::aid-cncr2820630829>3.0.co;2-y

Scopus ID

2-s2.0-0024524377 (requires institutional sign-in at Scopus site)   31 Citations

Abstract

Three children with acute lymphoblastic leukemia (ALL) developed isolated optic nerve relapse as the initial site of disease recurrence. They were part of an early cohort of 39 children with non-B-cell, non-T-cell ALL without central nervous system (CNS) involvement, treated regardless of initial leukocyte count with intrathecal chemotherapy for CNS prophylaxis. Although the optic nerve is a known site of relapse in patients with systemic and meningeal ALL, it has not been reported to occur in otherwise relapse-free patients. Early diagnosis and treatment prevented blindness and allowed for long-term survival (57+, 49+, and 97+ months, respectively) and possibly cure. Since these patients were treated in a new manner and exhibited a new pattern of relapse, their clinical courses were reviewed. Features considered worrisome, but not diagnostic of CNS leukemia may be of greater import when intrathecal medications are utilized as primary CNS prophylaxis. An expanded definition of CNS leukemia may be necessary.

Author List

Schwartz CL, Miller NR, Wharam MD, Leventhal BG

Author

Cindy L. Schwartz MD, MPH Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Child
Child, Preschool
Combined Modality Therapy
Cranial Nerve Neoplasms
Female
Humans
Male
Optic Nerve Diseases
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Recurrence
Remission Induction
Risk Factors