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Cytomegalovirus Retinitis during Maintenance Therapy in child with Acute Lymphoblastic Leukemia

M S Shah1, A A Rahman, M Begum

  • 1Dr Md Salahuddin Shah, Associate Professor, Department of Haematology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail: shah.fcps@ gmail.com.

Mymensingh Medical Journal : MMJ
|May 16, 2019
PubMed

Insights

Cytomegalovirus retinitis (CMVR) can affect children with acute lymphoblastic leukemia (ALL) during maintenance therapy. Early diagnosis and antiviral treatment are crucial for managing this vision-threatening complication in ALL patients.

Area of Science:

  • Ophthalmology
  • Pediatric Oncology
  • Infectious Diseases

Background:

  • Acute lymphoblastic leukemia (ALL) is a common childhood cancer requiring intensive treatment.
  • Maintenance therapy is a critical phase in ALL treatment to prevent relapse.
  • Cytomegalovirus (CMV) infections can occur in immunocompromised patients, including those with ALL.

Observation:

  • Three pediatric patients with ALL undergoing maintenance therapy presented with vision loss.
  • Ophthalmologic examinations revealed active cytomegalovirus retinitis (CMVR) in these patients.
  • The patients did not have a history of hematopoietic stem cell transplantation.

Findings:

  • Prompt diagnosis of CMVR was achieved through ophthalmologic evaluation.
  • Administration of specific anti-cytomegalovirus medications resulted in complete regression of active retinitis.
  • CMVR occurred in ALL patients even without hematopoietic stem cell transplantation.

Implications:

  • Cytomegalovirus retinitis should be considered in the differential diagnosis of vision changes in children with ALL on maintenance therapy.
  • Antiviral therapy is effective in treating CMVR in this patient population.
  • Routine ophthalmologic surveillance may be beneficial for children with ALL during maintenance therapy, regardless of transplantation status.

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