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Prognostic significance of retinopathy at presentation in adult acute leukemia

Prognostic significance of retinopathy at presentation in adult acute leukemia Retinal changes are common in adult acute leukemia patients at presentation, but their prognostic significance is controversial. A 5-year study has been carried out with newly diagnosed acute leukemia patients aged 12–77 years. Seventy-seven cases (49 AML, 28 ALL) were studied prospectively for the presence of intraretinal hemorrhages (IRH), white-centered hemorrhages, cotton-wool spots, and macular hemorrhages. They were treated according to standard chemotherapy protocols, and then achievement of complete remission (CR) and the duration of overall survival (OS) were compared between the groups with and without these different retinal features. No association was found between the presence of any retinal abnormality and CR induction rate, although there was a trend to a lower CR rate among patients with IRH. The median OS of those with IRH was 72 days, compared with 345 days among those without IRH ( p =0.002). A WBC at presentation greater than 50×l0 9 /l and age greater than 40 years were also associated with shorter OS ( p <0.0001 and p =0.0045, respectively). However, after regression analysis, IRH remained statistically significant as a poor prognostic indicator ( p =0.01).) We conclude that the presence of IRH is an indicator of poor prognosis in acute leukemia. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of Hematology Springer Journals

Prognostic significance of retinopathy at presentation in adult acute leukemia

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References (9)

Publisher
Springer Journals
Copyright
Copyright © 1998 by Springer-Verlag Berlin Heidelberg
Subject
Legacy
ISSN
0939-5555
eISSN
1432-0584
DOI
10.1007/s002770050354
Publisher site
See Article on Publisher Site

Abstract

Retinal changes are common in adult acute leukemia patients at presentation, but their prognostic significance is controversial. A 5-year study has been carried out with newly diagnosed acute leukemia patients aged 12–77 years. Seventy-seven cases (49 AML, 28 ALL) were studied prospectively for the presence of intraretinal hemorrhages (IRH), white-centered hemorrhages, cotton-wool spots, and macular hemorrhages. They were treated according to standard chemotherapy protocols, and then achievement of complete remission (CR) and the duration of overall survival (OS) were compared between the groups with and without these different retinal features. No association was found between the presence of any retinal abnormality and CR induction rate, although there was a trend to a lower CR rate among patients with IRH. The median OS of those with IRH was 72 days, compared with 345 days among those without IRH ( p =0.002). A WBC at presentation greater than 50×l0 9 /l and age greater than 40 years were also associated with shorter OS ( p <0.0001 and p =0.0045, respectively). However, after regression analysis, IRH remained statistically significant as a poor prognostic indicator ( p =0.01).) We conclude that the presence of IRH is an indicator of poor prognosis in acute leukemia.

Journal

Annals of HematologySpringer Journals

Published: Jan 1, 1998

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