Case report: Intravitreal methotrexate in intraocular acute lymphoblastic leukemia
Direct leukemic infiltration of the eye is most frequently associated with acute lymphoblastic leukemia (ALL), probably due to its well-known central nervous system (CNS) tropism. Systemic treatment alone may not be sufficient for intraocular leukemia. Data on local treatment are scarce. Here, we pr...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.951362/full |
| _version_ | 1818083524719149056 |
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| author | Matteo Pederzolli Matteo Pederzolli Fabio Giglio Maria Vittoria Cicinelli Maria Vittoria Cicinelli Alessandro Marchese Alessandro Marchese Giulio Modorati Giulio Modorati Sara Mastaglio Fabio Ciceri Fabio Ciceri Francesco Bandello Francesco Bandello Elisabetta Miserocchi Elisabetta Miserocchi |
| author_facet | Matteo Pederzolli Matteo Pederzolli Fabio Giglio Maria Vittoria Cicinelli Maria Vittoria Cicinelli Alessandro Marchese Alessandro Marchese Giulio Modorati Giulio Modorati Sara Mastaglio Fabio Ciceri Fabio Ciceri Francesco Bandello Francesco Bandello Elisabetta Miserocchi Elisabetta Miserocchi |
| author_sort | Matteo Pederzolli |
| collection | DOAJ |
| description | Direct leukemic infiltration of the eye is most frequently associated with acute lymphoblastic leukemia (ALL), probably due to its well-known central nervous system (CNS) tropism. Systemic treatment alone may not be sufficient for intraocular leukemia. Data on local treatment are scarce. Here, we present two cases of intraocular ALL treated with intravitreal methotrexate (MTX). Initially, anatomical improvement and visual stability were observed. The first patient experienced anatomical and visual worsening after a year of treatment. Treatment was withheld after 2 months for the second patient due to poor systemic conditions. Corneal toxicity and intraocular pressure elevation were observed in the first case. In both cases, eye involvement was associated with CNS or systemic relapse. This highlights the importance of incorporating ocular disease management in a comprehensive approach to therapy. Our experience corroborates previous findings on MTX injections as an effective and safe therapeutic option for intraocular leukemia. Further evidence is needed to consolidate the use of intravitreal MTX to treat such a debilitating localization of leukemia. |
| first_indexed | 2024-12-10T19:39:22Z |
| format | Article |
| id | doaj.art-85a525cd421248b0ae5177630640b18e |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-10T19:39:22Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-85a525cd421248b0ae5177630640b18e2022-12-22T01:36:02ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-08-011210.3389/fonc.2022.951362951362Case report: Intravitreal methotrexate in intraocular acute lymphoblastic leukemiaMatteo Pederzolli0Matteo Pederzolli1Fabio Giglio2Maria Vittoria Cicinelli3Maria Vittoria Cicinelli4Alessandro Marchese5Alessandro Marchese6Giulio Modorati7Giulio Modorati8Sara Mastaglio9Fabio Ciceri10Fabio Ciceri11Francesco Bandello12Francesco Bandello13Elisabetta Miserocchi14Elisabetta Miserocchi15School of Medicine, Vita-Salute San Raffaele University, Milan, ItalyDivision of Head and Neck, Ophthalmology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, Milan, ItalyHematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalySchool of Medicine, Vita-Salute San Raffaele University, Milan, ItalyDivision of Head and Neck, Ophthalmology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, Milan, ItalySchool of Medicine, Vita-Salute San Raffaele University, Milan, ItalyDivision of Head and Neck, Ophthalmology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, Milan, ItalySchool of Medicine, Vita-Salute San Raffaele University, Milan, ItalyDivision of Head and Neck, Ophthalmology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, Milan, ItalyHematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalySchool of Medicine, Vita-Salute San Raffaele University, Milan, ItalyHematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milan, ItalySchool of Medicine, Vita-Salute San Raffaele University, Milan, ItalyDivision of Head and Neck, Ophthalmology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, Milan, ItalySchool of Medicine, Vita-Salute San Raffaele University, Milan, ItalyDivision of Head and Neck, Ophthalmology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, Milan, ItalyDirect leukemic infiltration of the eye is most frequently associated with acute lymphoblastic leukemia (ALL), probably due to its well-known central nervous system (CNS) tropism. Systemic treatment alone may not be sufficient for intraocular leukemia. Data on local treatment are scarce. Here, we present two cases of intraocular ALL treated with intravitreal methotrexate (MTX). Initially, anatomical improvement and visual stability were observed. The first patient experienced anatomical and visual worsening after a year of treatment. Treatment was withheld after 2 months for the second patient due to poor systemic conditions. Corneal toxicity and intraocular pressure elevation were observed in the first case. In both cases, eye involvement was associated with CNS or systemic relapse. This highlights the importance of incorporating ocular disease management in a comprehensive approach to therapy. Our experience corroborates previous findings on MTX injections as an effective and safe therapeutic option for intraocular leukemia. Further evidence is needed to consolidate the use of intravitreal MTX to treat such a debilitating localization of leukemia.https://www.frontiersin.org/articles/10.3389/fonc.2022.951362/fullintraocular leukemiamethotrexateacute lymphoblastic leukemiaintravitreal injectionscase reportintravitreal methotrexate |
| spellingShingle | Matteo Pederzolli Matteo Pederzolli Fabio Giglio Maria Vittoria Cicinelli Maria Vittoria Cicinelli Alessandro Marchese Alessandro Marchese Giulio Modorati Giulio Modorati Sara Mastaglio Fabio Ciceri Fabio Ciceri Francesco Bandello Francesco Bandello Elisabetta Miserocchi Elisabetta Miserocchi Case report: Intravitreal methotrexate in intraocular acute lymphoblastic leukemia Frontiers in Oncology intraocular leukemia methotrexate acute lymphoblastic leukemia intravitreal injections case report intravitreal methotrexate |
| title | Case report: Intravitreal methotrexate in intraocular acute lymphoblastic leukemia |
| title_full | Case report: Intravitreal methotrexate in intraocular acute lymphoblastic leukemia |
| title_fullStr | Case report: Intravitreal methotrexate in intraocular acute lymphoblastic leukemia |
| title_full_unstemmed | Case report: Intravitreal methotrexate in intraocular acute lymphoblastic leukemia |
| title_short | Case report: Intravitreal methotrexate in intraocular acute lymphoblastic leukemia |
| title_sort | case report intravitreal methotrexate in intraocular acute lymphoblastic leukemia |
| topic | intraocular leukemia methotrexate acute lymphoblastic leukemia intravitreal injections case report intravitreal methotrexate |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.951362/full |
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