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Isolated Ocular Relapse in Childhood Acute Lymphoblastic Leukemia during Second Interim Maintenance Phase of Chemotherapy: Case Report

Chalinee Monsereenusorn MD*, Piya Rujkijyanont MD*, Worapot Srimanan MD**, Chanchai Traivaree MD, MSc*

Affiliation : * Division of Pediatric Hematology/Oncology, Department of Pediatrics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand ** Division of Pediatric Ophthalmology and Strabismus/Neuro-Ophthalmology, Department of Ophthalmology, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand

More than 80% of acute lymphoblastic leukemia (ALL) in pediatric population is curable by using combinations of chemotherapy. However, 20% of the cases still suffer from disease relapse. The most common site of relapse is bone marrow. Relapse of childhood ALL involving the eyeball is rare. However, it occurs in 2.2% of relapsing children. The authors described a 10-year-old Thai boy with underlying ALL on therapy, presented with a one-month history of progressive visual loss of his right eye. The clinical and imaging studies strongly suggested the diagnosis of isolated ocular relapse. In this report, the authors presented the findings from successfully specific treatment consisting of systemic chemotherapy and radiation therapy on the affected eye. From other studies, the outcome was more favorable in cases of ocular relapse off therapy. In our study, one case of isolated ocular relapse ALL was reported.

Keywords : Acute lymphoblastic leukemia, Isolated ocular relapse, Children


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