Akut Lenfoblastik Lösemide İzole Optik Sinir Relapsı: İki Olgu Sunumu

Yıl 2014, Cilt: 39 Sayı: 4, 0 - , 22.07.2014

Ayşen Türedi Yıldırım Yeşim Oymak Yöntem Yaman Osman Saatçi Rana Malatyalı Serra Kamer Hüdaver Alper

https://doi.org/10.17826/cutf.92975

Öz

Lösemili hastalarda yoğun kemoterapi, intratekal metotrexate tedavileri ve proflaktik santral sinir sistemi radyoterapisine rağmen ekstramedüller relapslar görülebilmektedir. Akut lenfoblastik lösemili hastalarda izole optik sinir relapsı nadir görülür ve kemik iliği tutulumu gelişmeden önce ani görme kaybı ile belirti verebilir. Erken tanı ve hızlı tedavi ile görüş kaybı tamamen düzeltilebilir. Burada izole optik sinir tutulumu ile relaps olan ve ani görme kaybı ile başvuran 10 ve 12 yaşlarında, pre-T akut lenfoblastik lösemili, iki erkek hasta literatür bilgileri eşliğinde tartışıldı.

Anahtar Kelimeler

Optik sinir relapsı, pre T akut lenfoblastik lösemi, Ani görme kaybı.

Isolated Optic Nerve Relapse in Acute Lymphoblastic Leukemia: Two Case Reports

Öz

Notwithstanding extensive chemotherapy, intrathecal methotrexate treatments and prophylactic central nervous system radiotherapy, extramedullary relapses can still be seen in leukemia patients. Isolated optic nerve relapses, one of its symptoms being a sudden vision loss that occurs prior to a bone marrow relapse, are rarely seen in acute lymphoblastic leukemia patients. Sudden vision loss can be cured by an early diagnosis and rapid treatment. In this study, we investigate two male patients (10 and 12 years old) with optic nerve relapses, sudden vision loss complaints and pre-T acute lymphoblastic leukemia in the light of the literature.

Anahtar Kelimeler

Optic nerve relapse, pre-T acute lymphoblastic leukemia, Sudden vision loss

Kaynakça

• Pui CH, Schrappe M, Ribeiro RC, Niemeyer CM. Childhood and adolescent lymphoid and myeloid leukemia. Hematology Am Soc Hematol Educ Program. 2004;118-45.
• Chessells JM, Bailey C, Richards SM. Intensification of treatment and survival in all children with lymphoblastic leukaemia: results of UK Medical Research Council trial. UKALL X. Lancet. 1995;345:143-8.
• Pui CH, Mullighan CG, Evans WE, Relling MV. Pediatric acute lymphoblastic leukemia: where are wegoing and how do we get there?Blood. 2012;120:1165-74.
• Surapaneni UR, Cortes JE, Thomas D, O’Brien S, Giles FJ, Koller C, Faderl S, Kantarjian H. Central nervous system relapse in adults with acute lymphoblastic leukemia. Cancer. 2002;94:773-9.
• Pui CH, Evans WE. Acute lymphoblastic leukemia. N Engl J Med. 1998;339:605-15.
• Mateo J, Ascaso JF, Nşñez E, Peiro C, González G, Cristóbal JA. Ophthalmological Manifestationsin Acute Lymphoblastic Leukemia. İn: Faderl S. (editör). Novel Aspects in Acute Lymphoblastic Leukemia. 1 th ed.Croatica 2011; http://www. intechopen. com/books/novel-aspects-in-acutelymphoblasticleukemia /ophthalmologicalmanifestations-in-acute-lymphoblastic-leukemia
• Russo V, Scott IU, Querques G, Stella A, Barone A, Delle Noci N. Orbital and ocular manifestations of acute childhood leukemia: clinical and statistical analysis of 180 patients. Eur J Ophthalmol. 2008;18:619-23.
• Lo Curto M, D’angelo P, Jankovik M, Fugardi MG, Ziino O, Casale F. Isolated ocular relapse in childhood acute lymphoblastic leucemia during complete remission. Haematologica. 1996;81:47-50.
• Charif Chefchaouni M, Belmekki M, Hajji Z, Tahiri H, Amrani R, El Bakkali M, Msefer Alaoui F, Berraho A. Ophthalmic manifestations of acute leukemia.J Fr Ophtalmol. 2002;25:62-6.
• Ohkoshi K, Tsiaras WG. Prognostic importance of ophthalmic manifestations in childhood leukaemia. British Journal of Ophthalmology. 1992;76:651-5.
• Ninane J, Taylor D, Day S. The eye as a sanctuary in acute lymphoblastic leukemia. Lancet. 1980;1:452–3.
• Somervaille TC, Hann IM, Harrison G, Eden TO, Gibson BE, Hill FG, Mitchell C, Kinsey SE, Vora AJ, Lilleyman JS; MRC Childhood Leukaemia Working Party. Intraocular relapse of childhood acute lymphoblastic leukaemia.Br J Haematol. 2003;121:280-8.
• Uckun FM, Gaynon PS, Stram DO, Sensel MG, Sarquis MB, Willoughby M. Bone marrow leukemic progenitor cell content in pediatric T-lineage acute lymphoblastic leukemia patients with an isolated extramedullary first relapse.Leuk Lymphoma. 2001;40:279-85.
• Zhang YL, Zhao WL, Nie SS, Guo DD, Ji ZH, Chai YH. Analysis of clinical features and prognostic significance of childhood T-lineage acute lymphoblastic leukemia. Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2011;19:1496-1500.
• Bandyopadhyay S, Das D, Das G, Gayen S. Unilateral optic nerve infiltration as an initial site of relapse of acute lymphoblastic leukemia in remission. Oman J Ophthalmol. 2010;3:153-4.
• Lin HF, Dai MS, Kao WY, Chao TY. Unilateral optic nerve leukemic infiltration with sudden vision loss heralding a systemic relapse of acute lymphoblastic leukemia. J Med Sci. 2005;25:97-100.
• Amer R, David R, Dotan S. Bilateral leukemic optic nerve infiltration as the first manifestation of extramedullary relapse in T-cell acute lymphoblastic leukemia.Harefuah. 2013;152:112-4.
• Yazışma Adresi / Address for Correspondence: Dr. Ayşen Türedi Yıldırım Celal Bayar Üniversitesi Tıp Fakültesi Hastanesi Çocuk Hematoloji Kliniği Uncubozköy Y erleşkesi MAN İSA E-mail: [e-mail] G eliş tarihi/Received on :24.03.2014
• Kabul tarihi/Accepted on: 02.05.2014