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About 85-90% of children with B-cell leukaemia are cured.
If relapse occurs it is usually in the bone marrow (BM),
followed by extramedullary sites. Ocular lesions occur
secondary to the accumulation of circulating blasts in the
uvea, optic disc, intra-ocular tissue as well as fluid. Here
we report four patients with ocular complaints that led to
the diagnosis of relapse. Among 475 children with
leukaemia treated from January 2013 to December 2018,
50 (10.5%) patients relapsed. Four (8%) out of these 50
presented with orbital symptoms. Central Nervous
System (CNS) evaluation by cerebrospinal fluid (CSF) was
negative at relapse. Relapse was treated with
chemotherapy R3 protocol. Three (75%) patients are alive,
while the fourth patient had a second BM relapse and
died. Ophthalmic signs and symptoms in patients with
treated leukaemia warrant a thorough evaluation. These
signs can be an indication of relapse. BM and CSF studies
should be done for diagnosing relapse.
Komal Seher, Saadiya Javed Khan. (2021) Orbital relapse in children treated for Pre-B ALL, a retrospective case series , Journal of the Pakistan Medical Association, Volume 71, Issue 1.
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