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



Pubmed ID




Scopus ID

2-s2.0-0024524377   25 Citations


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


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

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

Child, Preschool
Combined Modality Therapy
Cranial Nerve Neoplasms
Optic Nerve Diseases
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Remission Induction
Risk Factors
jenkins-FCD Prod-461 7d7c6113fc1a2757d2947d29fae5861c878125ab