TY - JOUR
T1 - Cytomegalovirus Disease in Children with Acute Lymphoblastic Leukemia in the Nontransplant Setting
T2 - Case Series and Review of the Literature
AU - Rahbarimanesh, Aliakbar
AU - Ehsani, Mohammadali
AU - Karahroudi, Maedeh
AU - Rashidi, Armin
AU - Aghajani, Motahareh
AU - Meysami, Alipasha
AU - Shahgholi, Elham
AU - Mehrvar, Azim
AU - Tashvighi, Maryam
AU - Keyvani, Hossein
PY - 2015/8/6
Y1 - 2015/8/6
N2 - Cytomegalovirus (CMV) disease in pediatric acute lymphoblastic leukemia in the nontransplant setting is very rare. We report our experience with 4 such cases, and review the literature (n=12). The median age at diagnosis was 10 years and 50% of patients were males. Among the 11 cases with available information at the time of diagnosis, CMV disease occurred during maintenance therapy in 10 patients. Fever was present in 9 cases. CMV disease manifested as retinitis in 6, hepatosplenic disease in 3, pneumonitis in 1, and hemophagocytic lymphohistiocytosis in 1 patient. One patient had both CMV retinitis and CMV-related hemophagocytic lymphohistiocytosis. Four of the 7 patients with retinitis complained of visual disturbance at diagnosis. CMV viremia was present in 10 patients. Three patients had at least 1 relapse and developed permanent visual defects, and 1 patient developed recurrent retinal detachment. In conclusion, prolonged immunosuppression is the major etiology and retinitis is the most common manifestation of CMV disease. As a significant number of patients with retinitis are asymptomatic, early diagnosis and treatment is important to prevent permanent visual loss. ©
AB - Cytomegalovirus (CMV) disease in pediatric acute lymphoblastic leukemia in the nontransplant setting is very rare. We report our experience with 4 such cases, and review the literature (n=12). The median age at diagnosis was 10 years and 50% of patients were males. Among the 11 cases with available information at the time of diagnosis, CMV disease occurred during maintenance therapy in 10 patients. Fever was present in 9 cases. CMV disease manifested as retinitis in 6, hepatosplenic disease in 3, pneumonitis in 1, and hemophagocytic lymphohistiocytosis in 1 patient. One patient had both CMV retinitis and CMV-related hemophagocytic lymphohistiocytosis. Four of the 7 patients with retinitis complained of visual disturbance at diagnosis. CMV viremia was present in 10 patients. Three patients had at least 1 relapse and developed permanent visual defects, and 1 patient developed recurrent retinal detachment. In conclusion, prolonged immunosuppression is the major etiology and retinitis is the most common manifestation of CMV disease. As a significant number of patients with retinitis are asymptomatic, early diagnosis and treatment is important to prevent permanent visual loss. ©
KW - CMV
KW - ganciclovir
KW - leukemia
KW - lymphoblastic
KW - retinitis
KW - valganciclovir
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U2 - 10.1097/MPH.0000000000000298
DO - 10.1097/MPH.0000000000000298
M3 - Article
C2 - 25521083
AN - SCOPUS:84938738303
SN - 1077-4114
VL - 37
SP - 429
EP - 432
JO - Journal of pediatric hematology/oncology
JF - Journal of pediatric hematology/oncology
IS - 6
ER -