Harnett A N, Plowman P N
Department of Radiotherapy, St. Bartholomew's Hospital, West Smithfield, London, U.K.
Radiother Oncol. 1987 Nov;10(3):203-7. doi: 10.1016/s0167-8140(87)80006-3.
Solitary relapse of acute lymphoblastic leukaemia (ALL) was diagnosed in the anterior chamber of the eye in five children. In all these cases, pathological confirmation of the diagnosis was obtained and there was no other evidence of relapse including cerebrospinal fluid (CSF) and bone marrow examinations. Each child had one adverse prognostic sign at the initial presentation (high white blood cell count, age or sex). Relapse always occurred soon after completion of maintenance chemotherapy (between one and 4 months), supporting the hypothesis that the eye is a pharmacological sanctuary to cytotoxic chemotherapeutic drugs. Radiotherapy to the involved orbit was given with an immediate response in all patients. The details of this treatment are discussed. Four of the five patients later relapsed, one locally and three in bone marrow; the prognosis of solitary ocular relapse therefore appears grave.
5名儿童被诊断为急性淋巴细胞白血病（ALL）孤立性眼部复发，病变位于前房。所有这些病例均经病理确诊，且无其他复发证据，包括脑脊液（CSF）和骨髓检查。每个儿童在初次就诊时均有一个不良预后体征（高白细胞计数、年龄或性别）。复发总是在维持化疗结束后不久（1至4个月之间）发生，这支持了眼睛是细胞毒性化疗药物的一个药物庇护所这一假说。对受累眼眶进行放射治疗后，所有患者均立即出现反应。文中讨论了该治疗的详细情况。5名患者中有4名后来复发，1名局部复发，3名骨髓复发；因此，孤立性眼部复发的预后似乎很严重。
