Cytomegalovirus retinitis as an adverse immunological effect of pulses of vincristine and dexamethasone in maintenance therapy for childhood acute lymphoblastic leukemia

Pediatr Blood Cancer. 2013 Feb;60(2):329-31. doi: 10.1002/pbc.24298. Epub 2012 Sep 13.

Abstract

We describe a 5-year-old female with acute lymphoblastic leukemia (ALL) who suffered from cytomegalovirus (CMV) retinitis during maintenance therapy consisting of 6-mercaptopurine (6-MP) and methotrexate (MTX) with pulses of vincristine (VCR) and dexamethasone (DEX). Administration of anticytomegaloviral drugs led to a complete regression of active retinitis. Her low CD4 positive T cells and serum immunoglobulin G (IgG) recovered when maintenance therapy was resumed without VCR and DEX. The patient has been in complete remission (CR) for more than 5 months after completion of maintenance therapy without recurrence of CMV retinitis.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Child, Preschool
  • Cytomegalovirus Retinitis / chemically induced*
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects
  • Female
  • Humans
  • Maintenance Chemotherapy / adverse effects*
  • Maintenance Chemotherapy / methods
  • Mercaptopurine / administration & dosage
  • Mercaptopurine / adverse effects
  • Methotrexate / administration & dosage
  • Methotrexate / adverse effects
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Vincristine / administration & dosage
  • Vincristine / adverse effects

Substances

  • Vincristine
  • Dexamethasone
  • Mercaptopurine
  • Methotrexate