gms | German Medical Science

104th DOG Annual Meeting

21. - 24.09.2006, Berlin

Ocular manifestation of relapse of acute lymphoblastic leukemia in two teenagers

Meeting Abstract

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  • A. V. Furmanchuk - Byelorussian Research Center for Pediatric Oncology and Hematology, Minsk, Belarus

Deutsche Ophthalmologische Gesellschaft e.V.. 104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft (DOG). Berlin, 21.-24.09.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06dogP003

The electronic version of this article is the complete one and can be found online at:

Published: September 18, 2006

© 2006 Furmanchuk.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




Analysis of two cases of intraocular manifestation of isolated relapse in two patients after completion of ALL treatment.


The single case analysis of two young female patients (13 and 15 years at diagnosis), who received treatment for ALL in our clinic and returned to ophthalmologist with complaints of decrease in visual acuity. The first patient (ALL, L1 (FAB), pre-B immunophenotype with weak coexpression of CD33 and MPO, RF-1.5) completed the ALL-BFM-90 protocol with auto-BMT and prophylactic cranial irradiation in dose of 18 Gr. Diagnosis of relapse had been established after enucleation of painful blind eye. First patient of standard risk group followed the ALL-REZ BFM 2002, arm B, and underwent irradiation of orbital tissue (total dose of 40 Gr). Second patient (ALL, L1 (FAB), common B, HRG (BCR/ABL (9:22)) followed ALL-МВ-2002 with prophylactic cranial irradiation in dose of 12 Gr. For the diagnosis of relapse, anterior chamber punction was performed and blasts obtained. Second patient with early relapse (high risk group) followed the ALL-REZ BFM 2002 with non-relative allo-BMT.


First patient developed late relapse with intraocular manifestation of severe steroid-resistant anterior uveitis with pseudohypopyon, opticoneuroretinitis, secondary exudative retinal detachment and neovascular glaucoma on one eye. She is still alive (5 months after completion of treatment) with intact other eye suffering of poor vision due to diffuse retinopathy and secondary cataract. Second patient developed eye problems 3 months after last re-induction, complaining on deterioration of vision and manifesting with monocular anterior uveitis and pseudohypopyon. After two weeks of resistance to local steroid therapy, diagnosis of relapse was established and treatment initiated. She died of sepsis and multiorgan failure at 108th day after allo-BMT.


Complaints on decrease in visual acuity, deterioration of vision, change in color perception, steroid-resistant course of uveitis in patients after completion of treatment for leukemia should be considered with special attention for possible site of relapse of main disease. Punction of anterior chamber and analysis of intraocular liquid is extremely important for establishing intraocular isolated relapse and initiating treatment.