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Ocular toxicity from high-dose cytosine arabinoside
Cancer
|February 1, 1983
Summary
High-dose cytosine arabinoside (CA) can cause severe ocular toxicity in leukemia patients, including corneal opacities and vision loss. Toxicity appears dose- and duration-dependent, necessitating strategies to mitigate this adverse effect.
Area of Science:
- Oncology
- Ophthalmology
- Pharmacology
Background:
- Acute myelogenous leukemia (AML) is a hematologic malignancy.
- High-dose chemotherapy, including cytosine arabinoside (CA), is a treatment option for refractory AML.
Observation:
- A patient receiving high-dose CA (3.0 g/m2 every 12 hours) for refractory AML developed significant ocular toxicity.
- Symptoms included excessive tearing, photophobia, ocular pain, blurred vision, conjunctival injection, and corneal opacities.
Findings:
- Ocular toxicity was linked to the high dose and prolonged duration of CA therapy.
- Lower doses or shorter durations of CA were well-tolerated without ocular side effects.
- Corneal opacities and visual acuity impairment resolved over 2-4 weeks post-therapy.
Implications:
- Ocular toxicity is a potential treatment-limiting adverse effect of high-dose CA in AML.
- Corneal epithelial DNA synthesis inhibition is the suspected mechanism.
- Further research is needed to develop strategies for preventing or managing CA-induced ocular toxicity.