Prevalence and risk factors of cataract after chemotherapy with or without central nervous system irradiation for childhood acute lymphoblastic leukaemia: an LEA study
Anne-Lise Alloin
Department of Paediatric Haematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, Marseille, France
Search for more papers by this authorVincent Barlogis
Department of Paediatric Haematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, Marseille, France
Search for more papers by this authorPascal Auquier
Department of Public Health -EA 3279 Research Unit, University Hospital Marseille, Aix-Marseille University, Marseille, France
Search for more papers by this authorAudrey Contet
Department of Paediatric Haematology-Oncology, University Hospital of Nancy, Nancy, France
Search for more papers by this authorMaryline Poiree
Department of Paediatric Haematology-Oncology, University Hospital of Nice, Nice, France
Search for more papers by this authorFrançois Demeocq
Department of Paediatric Haematology-Oncology, CIC Inserm 501, University Hospital of Clermont Ferrand, Clermont Ferrand, France
Search for more papers by this authorIris Herrmann
Department of Paediatric Haematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, Marseille, France
Search for more papers by this authorVirginie Villes
Department of Public Health -EA 3279 Research Unit, University Hospital Marseille, Aix-Marseille University, Marseille, France
Search for more papers by this authorYves Bertrand
Department of Paediatric Haematology-Oncology, University Hospital of Lyon, Lyon, France
Search for more papers by this authorDominique Plantaz
Department of Paediatric Haematology-Oncology, University Hospital of Grenoble, Grenoble, France
Search for more papers by this authorJustyna Kanold
Department of Paediatric Haematology-Oncology, CIC Inserm 501, University Hospital of Clermont Ferrand, Clermont Ferrand, France
Search for more papers by this authorPascal Chastagner
Department of Paediatric Haematology-Oncology, University Hospital of Nancy, Nancy, France
Search for more papers by this authorHervé Chambost
Department of Paediatric Haematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, Marseille, France
Search for more papers by this authorNicolas Sirvent
Department of Paediatric Haematology-Oncology, University Hospital of Montpellier, Montpellier, France
Search for more papers by this authorCorresponding Author
Gérard Michel
Department of Paediatric Haematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, Marseille, France
Department of Public Health -EA 3279 Research Unit, University Hospital Marseille, Aix-Marseille University, Marseille, France
Correspondence: Gérard Michel, Department of Paediatric Haematology-Oncology, Hôpital pour Enfants La Timone, Rue St Pierre, Marseille 13385, France.
E-mail: [email protected]
Search for more papers by this authorAnne-Lise Alloin
Department of Paediatric Haematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, Marseille, France
Search for more papers by this authorVincent Barlogis
Department of Paediatric Haematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, Marseille, France
Search for more papers by this authorPascal Auquier
Department of Public Health -EA 3279 Research Unit, University Hospital Marseille, Aix-Marseille University, Marseille, France
Search for more papers by this authorAudrey Contet
Department of Paediatric Haematology-Oncology, University Hospital of Nancy, Nancy, France
Search for more papers by this authorMaryline Poiree
Department of Paediatric Haematology-Oncology, University Hospital of Nice, Nice, France
Search for more papers by this authorFrançois Demeocq
Department of Paediatric Haematology-Oncology, CIC Inserm 501, University Hospital of Clermont Ferrand, Clermont Ferrand, France
Search for more papers by this authorIris Herrmann
Department of Paediatric Haematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, Marseille, France
Search for more papers by this authorVirginie Villes
Department of Public Health -EA 3279 Research Unit, University Hospital Marseille, Aix-Marseille University, Marseille, France
Search for more papers by this authorYves Bertrand
Department of Paediatric Haematology-Oncology, University Hospital of Lyon, Lyon, France
Search for more papers by this authorDominique Plantaz
Department of Paediatric Haematology-Oncology, University Hospital of Grenoble, Grenoble, France
Search for more papers by this authorJustyna Kanold
Department of Paediatric Haematology-Oncology, CIC Inserm 501, University Hospital of Clermont Ferrand, Clermont Ferrand, France
Search for more papers by this authorPascal Chastagner
Department of Paediatric Haematology-Oncology, University Hospital of Nancy, Nancy, France
Search for more papers by this authorHervé Chambost
Department of Paediatric Haematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, Marseille, France
Search for more papers by this authorNicolas Sirvent
Department of Paediatric Haematology-Oncology, University Hospital of Montpellier, Montpellier, France
Search for more papers by this authorCorresponding Author
Gérard Michel
Department of Paediatric Haematology-Oncology, APHM, La Timone Hospital, Aix-Marseille University, Marseille, France
Department of Public Health -EA 3279 Research Unit, University Hospital Marseille, Aix-Marseille University, Marseille, France
Correspondence: Gérard Michel, Department of Paediatric Haematology-Oncology, Hôpital pour Enfants La Timone, Rue St Pierre, Marseille 13385, France.
E-mail: [email protected]
Search for more papers by this authorSummary
Corticosteroid and central nervous system (CNS) irradiation can induce cataract in childhood lymphoblastic leukaemia survivors. Few prospective studies with systematic ophthalmological evaluation have been published. Cataract was prospectively assessed by serial slip lamp tests in 517 patients. All had acute lymphoblastic leukaemia, all had been treated by chemotherapy with or without CNS irradiation, and none had received haematopoietic stem cell transplantation. Median ages at last evaluation and follow-up duration from leukaemia diagnosis were 16·8 and 10·9 years, respectively. Cataract was observed in 21/517 patients (4·1%). Cumulative incidence was 4·5 ± 1·2% at 15 years and reached 26 ± 8·1% at 25 years. CNS irradiation was the only risk factor: prevalence was 11·1% in patients who had received irradiation and 2·8% in those who did not. We did not detect any steroid dose effect: cumulative dose was 5133 and 5190 mg/m2 in patients with and without cataract, respectively. Cataract occurrence did not significantly impact quality of life. We conclude that, in the range of steroid dose reported here, the cataract risk proves very low 15 years after treatment without CNS irradiation but an even more prolonged follow-up is required because of potential very late occurrence.
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