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Ophthalmologic findings and complications before and after hematopoietic stem cell transplantation: single-center
Hakan Sarbay1, Samira Hagverdiyeva2, Emine Turkkan3
1Pediatric Hematology and Oncology, Bone Marrow Transplantation Unit, TC Istanbul Yeni Yuzyil University Faculty of Medicine, Istanbul, Turkey. drhakansarbay@hotmail.com.
Insights
Ophthalmologic complications can occur after hematopoietic stem cell transplantation (HSCT). Early diagnosis through routine eye exams and prophylaxis for graft-versus-host disease (GvHD) and cytomegalovirus (CMV) can reduce risks.
Area of Science:
- Pediatric Hematology
- Ophthalmology
- Transplant Medicine
Background:
- Hematopoietic stem cell transplantation (HSCT) can lead to various systemic complications and late effects.
- Ophthalmologic complications are a potential concern following HSCT, impacting patient outcomes.
Purpose of the Study:
- To investigate the frequency of ophthalmologic complications in children undergoing HSCT.
- To explore the relationship between these ocular complications and HSCT treatment modalities.
Main Methods:
- Retrospective analysis of 104 pediatric patients who underwent HSCT between February 2019 and June 2020.
- Evaluation of patient demographics, diagnoses, transplant types, conditioning regimens, GvHD prophylaxis, infections, and ophthalmologic findings.
- Specific assessment of ocular pathology before and after HSCT.
Main Results:
- The study included 104 children (36.5% female, 63.5% male) with a mean age of 8.7 years.
- Acute lymphoblastic leukemia was the most common diagnosis (44%). Myeloablative regimens were predominantly used (89%).
- Ocular pathology was present in 19% before HSCT and 12% after HSCT, with dry eye being the most frequent condition. CMV reactivation occurred in 51% but CMV retinitis was not observed.
Conclusions:
- Routine ophthalmologic examinations are crucial for the early detection of ocular complications post-HSCT.
- Effective prophylaxis against GvHD and CMV infections is essential for mitigating the risk of developing ocular complications after HSCT.
Purpose:
Different and various system complications and late effects may occur after hematopoietic stem cell transplantation (HSCT). It was aimed to obtain information about the frequency of ophthalmologic complications and their relationship with treatment.
Methods:
This retrospective study includes 104 children who underwent HSCT between February 2019 and June 2020 at the Pediatric Bone Marrow Transplant Unit. Patients' ages, genders, diagnosis, transplant types, chemotherapy regimens, transplantation details, conditioning regimens, supportive cares, graft versus host disease (GvHD) prophylaxis, infection episodes, and ophthalmologic findings were evaluated.
Results:
Of the 104 patients included in the study, 38 (36.5%) were female and 66 (63.5%) were male. Average age ± SD was 8.7 ± 4.91. Considering the diagnoses, the majority of the patients were acute lymphoblastic leukemia (46 patients-44%). Myeloablative regimen was used in 93 (89%) of the patients, and reduced intensity conditioning (RIC) was used in 11 patients (10%). While total body irradiation was applied in 16 (15%) patients, one patient was received cranial radiotherapy. Cyclosporine was used in 96 (92%) patients. CMV reactivation was detected in 54 (51%) of the patients. CMV retinitis was not seen. Ocular pathology was detected in 20 (19%) patients before HSCT and in 12 (11%) patients after HSCT. The most common pathology was dry eye.
Conclusion:
Routine ophthalmologic examinations are important in terms of early diagnosis. In addition, GvHD and CMV prophylaxis is important because of reducing the risk of ocular complications after HSCT.
