Orbital and ocular manifestations of acute childhood leukemia: Clinical and statistical analysis of 180 patients

Vincenzo Russo, I. U. Scott, G. Querques, A. Stella, A. Barone, N. Delle Noci

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Abstract

PURPOSE. To investigate the association between presence of orbital or ocular lesions and type and stage of leukemia and to investigate whether orbital and ocular lesions are significant in predicting leukemia prognosis. METHODS. The authors evaluated 180 patients with acute childhood leukemia. Lesions associated with leukemia may be classified as specific (due to leukemic infiltration of various ocular tissues), nonspecific (due to one of the secondary complications), or iatrogenic manifestations caused by chemotherapy. Risk-based treatment assignment is based on clinical and laboratory features at diagnosis. Children with presenting white blood cell count below 50,000 mm 3 are considered at standard risk for treatment failure, while all others are considered at high risk for treatment failure. RESULTS. Specific lesions were noted in 66% of patients with acute myeloid leukemia (AML) and 11.5% patients with acute lymphocytic leukemia (ALL) (p<0.05), and were more severe in patients with high risk leukemia than in patients with standard risk leukemia. Orbital or ocular lesions were noted more commonly in patients with AML (66.6%) compared to patients with ALL (15.1%). In both the AML and ALL groups, there was a higher frequency of leukemic relapses in the bone marrow and/or central nervous system in patients with specific lesions (63.1%) compared to patients with nonspecific lesions (42%), and in patients without orbital or ocular lesions (29.2%) (p<0.05). CONCLUSIONS. In both the AML and ALL groups, the presence of specific orbital or ocular lesions was associated with a higher frequency of bone marrow relapses and CNS involvement (p<0.05), leading to a lower survival rate.

Original languageEnglish (US)
Pages (from-to)619-623
Number of pages5
JournalEuropean Journal of Ophthalmology
Volume18
Issue number4
StatePublished - Jul 1 2008

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Eye Manifestations
Leukemia
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Acute Myeloid Leukemia
Treatment Failure
Bone Marrow
Leukemic Infiltration
Recurrence
Leukocyte Count

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Russo, Vincenzo ; Scott, I. U. ; Querques, G. ; Stella, A. ; Barone, A. ; Delle Noci, N. / Orbital and ocular manifestations of acute childhood leukemia : Clinical and statistical analysis of 180 patients. In: European Journal of Ophthalmology. 2008 ; Vol. 18, No. 4. pp. 619-623.
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abstract = "PURPOSE. To investigate the association between presence of orbital or ocular lesions and type and stage of leukemia and to investigate whether orbital and ocular lesions are significant in predicting leukemia prognosis. METHODS. The authors evaluated 180 patients with acute childhood leukemia. Lesions associated with leukemia may be classified as specific (due to leukemic infiltration of various ocular tissues), nonspecific (due to one of the secondary complications), or iatrogenic manifestations caused by chemotherapy. Risk-based treatment assignment is based on clinical and laboratory features at diagnosis. Children with presenting white blood cell count below 50,000 mm 3 are considered at standard risk for treatment failure, while all others are considered at high risk for treatment failure. RESULTS. Specific lesions were noted in 66{\%} of patients with acute myeloid leukemia (AML) and 11.5{\%} patients with acute lymphocytic leukemia (ALL) (p<0.05), and were more severe in patients with high risk leukemia than in patients with standard risk leukemia. Orbital or ocular lesions were noted more commonly in patients with AML (66.6{\%}) compared to patients with ALL (15.1{\%}). In both the AML and ALL groups, there was a higher frequency of leukemic relapses in the bone marrow and/or central nervous system in patients with specific lesions (63.1{\%}) compared to patients with nonspecific lesions (42{\%}), and in patients without orbital or ocular lesions (29.2{\%}) (p<0.05). CONCLUSIONS. In both the AML and ALL groups, the presence of specific orbital or ocular lesions was associated with a higher frequency of bone marrow relapses and CNS involvement (p<0.05), leading to a lower survival rate.",
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Orbital and ocular manifestations of acute childhood leukemia : Clinical and statistical analysis of 180 patients. / Russo, Vincenzo; Scott, I. U.; Querques, G.; Stella, A.; Barone, A.; Delle Noci, N.

In: European Journal of Ophthalmology, Vol. 18, No. 4, 01.07.2008, p. 619-623.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Orbital and ocular manifestations of acute childhood leukemia

T2 - Clinical and statistical analysis of 180 patients

AU - Russo, Vincenzo

AU - Scott, I. U.

AU - Querques, G.

AU - Stella, A.

AU - Barone, A.

AU - Delle Noci, N.

PY - 2008/7/1

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N2 - PURPOSE. To investigate the association between presence of orbital or ocular lesions and type and stage of leukemia and to investigate whether orbital and ocular lesions are significant in predicting leukemia prognosis. METHODS. The authors evaluated 180 patients with acute childhood leukemia. Lesions associated with leukemia may be classified as specific (due to leukemic infiltration of various ocular tissues), nonspecific (due to one of the secondary complications), or iatrogenic manifestations caused by chemotherapy. Risk-based treatment assignment is based on clinical and laboratory features at diagnosis. Children with presenting white blood cell count below 50,000 mm 3 are considered at standard risk for treatment failure, while all others are considered at high risk for treatment failure. RESULTS. Specific lesions were noted in 66% of patients with acute myeloid leukemia (AML) and 11.5% patients with acute lymphocytic leukemia (ALL) (p<0.05), and were more severe in patients with high risk leukemia than in patients with standard risk leukemia. Orbital or ocular lesions were noted more commonly in patients with AML (66.6%) compared to patients with ALL (15.1%). In both the AML and ALL groups, there was a higher frequency of leukemic relapses in the bone marrow and/or central nervous system in patients with specific lesions (63.1%) compared to patients with nonspecific lesions (42%), and in patients without orbital or ocular lesions (29.2%) (p<0.05). CONCLUSIONS. In both the AML and ALL groups, the presence of specific orbital or ocular lesions was associated with a higher frequency of bone marrow relapses and CNS involvement (p<0.05), leading to a lower survival rate.

AB - PURPOSE. To investigate the association between presence of orbital or ocular lesions and type and stage of leukemia and to investigate whether orbital and ocular lesions are significant in predicting leukemia prognosis. METHODS. The authors evaluated 180 patients with acute childhood leukemia. Lesions associated with leukemia may be classified as specific (due to leukemic infiltration of various ocular tissues), nonspecific (due to one of the secondary complications), or iatrogenic manifestations caused by chemotherapy. Risk-based treatment assignment is based on clinical and laboratory features at diagnosis. Children with presenting white blood cell count below 50,000 mm 3 are considered at standard risk for treatment failure, while all others are considered at high risk for treatment failure. RESULTS. Specific lesions were noted in 66% of patients with acute myeloid leukemia (AML) and 11.5% patients with acute lymphocytic leukemia (ALL) (p<0.05), and were more severe in patients with high risk leukemia than in patients with standard risk leukemia. Orbital or ocular lesions were noted more commonly in patients with AML (66.6%) compared to patients with ALL (15.1%). In both the AML and ALL groups, there was a higher frequency of leukemic relapses in the bone marrow and/or central nervous system in patients with specific lesions (63.1%) compared to patients with nonspecific lesions (42%), and in patients without orbital or ocular lesions (29.2%) (p<0.05). CONCLUSIONS. In both the AML and ALL groups, the presence of specific orbital or ocular lesions was associated with a higher frequency of bone marrow relapses and CNS involvement (p<0.05), leading to a lower survival rate.

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