IngentaConnect Intraocular relapse of childhood acute lymphoblastic leukaemia

Authors: Somervaille T.C.P.¹; Hann I.M.¹; Harrison G.²; Eden T.O.B.³; Gibson B.E.⁴; Hill F.G.⁵; Mitchell C.⁶; Kinsey S.E.⁷; Vora A.J.⁸; Lilleyman J.S.⁹

Source: British Journal of Haematology, Volume 121, Number 2, April 2003 , pp. 280-288(9)

Publisher: Blackwell Publishing

Abstract:

Summary.

Relapse of childhood acute lymphoblastic leukaemia (ALL) involving the eye is a rare but challenging problem. Twenty cases occurred in patients treated on the Medical Research Council United Kingdom Acute Lymphoblastic Leukaemia XI and ALL97 trials between 1991 and 2001, representing 2·2% of ALL relapses. Seventeen occurred as a first relapse, either in isolation or combined with relapse at another site, and three occurred as a second relapse. All patients with intraocular disease at first relapse were treated with both chemotherapy and radiotherapy, but the doses and protocols used varied. Eleven of these 17 patients are alive and in complete remission with a median follow up of 4 years 2 months from relapse. All 11 children that were treated with a full chemotherapy relapse protocol, together with local radiotherapy have survived. Patients treated with chemotherapy of shorter duration and intensity, despite radiotherapy and/or bone marrow transplantation, did poorly with only one survivor, currently in chronic relapse. Consequently, we suggest that children with eye relapse of ALL be treated with an intensive relapse chemotherapy protocol with local ocular radiotherapy, whether the relapse occurs in isolation or in combination with relapse at another site.

Keywords: childhood acute lymphoblastic leukaemia; ocular relapse; eye

Document Type: Research article

DOI: 10.1046/j.1365-2141.2003.04280.x

Affiliations: 1: Great Ormond Street Hospital for Children NHS Trust, London, 2: Clinical Trial Service Unit, Radcliffe Infirmary, Oxford, 3: Academic Unit of Paediatric Oncology, Christie and Central Manchester and Manchester Children's Hospitals, Manchester, 4: Royal Hospital for Sick Children, Yorkhill, Glasgow, 5: Children's Hospital, Birmingham, 6: John Radcliffe Hospital, Oxford, 7: Children's Day Hospital, St James University Hospital, Leeds, 8: The Children's Hospital, Sheffield, and 9: The Royal London Hospital, London, UK

The full text electronic article is available for purchase. You will be able to download the full text electronic article after payment.

$43.08 plus tax