Anterior chamber infiltration in a patient with Ph+ acute lymphoblastic leukemia in remission with imatinib

Am J Ophthalmol. 2005 Apr;139(4):723-4. doi: 10.1016/j.ajo.2004.09.075.

Abstract

Purpose: Anterior chamber involvement is unusual in patients with acute lymphoblastic leukemia (ALL) and has never been described in the setting of Ph+ (Philadelphia chromosome-positive) ALL. Moreover, there have been no reports of this complication as a primary relapse in a patient treated with imatinib.

Design: Interventional case report.

Methods: A 55-year-old woman with Ph+ ALL in complete remission with imatinib and presenting unilateral anterior uveitis at initial examination was clinically evaluated. Hematologic and ocular studies were performed: blood films, bone marrow smears, and anterior chamber paracentesis with aqueous fluid cytology.

Results: Although there was no evidence of leukemia in the blood or bone marrow samples, aqueous fluid cytology identified Ph+ positive lymphoblastic leukemic cells.

Conclusions: The patient had developed anterior chamber infiltration without hematological relapse while treated with imatinib. In our opinion, paracentesis should be performed without delay when uveitis develops in ALL, regardless of systemic relapse.

Publication types

  • Case Reports

MeSH terms

  • Anterior Chamber / pathology*
  • Antineoplastic Agents / therapeutic use*
  • Aqueous Humor / cytology
  • Benzamides
  • Eye Neoplasms / pathology*
  • Female
  • Humans
  • Imatinib Mesylate
  • In Situ Hybridization, Fluorescence
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy*
  • Leukemic Infiltration / pathology*
  • Middle Aged
  • Philadelphia Chromosome
  • Piperazines / therapeutic use*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Pyrimidines / therapeutic use*
  • Remission Induction
  • Uveitis, Anterior / diagnosis

Substances

  • Antineoplastic Agents
  • Benzamides
  • Piperazines
  • Pyrimidines
  • Imatinib Mesylate