@article {1638578,
	title = {Ocular abnormalities at diagnosis and after the completion of treatment in children and adolescents with newly diagnosed acute lymphoblastic leukemia},
	journal = {Pediatr Blood Cancer},
	volume = {69},
	number = {4},
	year = {2022},
	month = {2022 Apr},
	pages = {e29542},
	abstract = {BACKGROUND: Ocular abnormalities (OA) in pediatric patients with acute lymphoblastic leukemia (ALL) are common findings both at diagnosis and later in follow-up. The frequency, predictors, and prognostic impact of OA in the context of recent ALL protocols are not well characterized. PROCEDURE: Single-center retrospective analysis of the medical records of 224 patients with ALL enrolled on Dana-Farber Cancer Institute (DFCI) ALL Consortium Protocol 05-001. RESULTS: Overall, 217 (98\%) patients had at least one ophthalmic exam. Retinal hemorrhages were the most frequent abnormalities at diagnosis (11\%) and cataracts at later time points (13\%). OA at diagnosis were associated with age >=10\&nbsp;years and with the severity of anemia and thrombocytopenia; they were also univariately associated with lower 5-year event-free survival (EFS) (high risk [HR]\&nbsp;=\&nbsp;3.09 [95\% CI: 1.38-6.94]; p\&nbsp;=\&nbsp;.006), but not in a disease-free survival (DFS) model adjusted for end-induction minimal residual disease (p\&nbsp;=\&nbsp;.82). The cumulative incidence of cataract was 13.1\% {\textpm} 2.8\% at 43\&nbsp;months from diagnosis; its development was associated with high presenting white blood cell count (>=50,000/μl) (p\&nbsp;=\&nbsp;.010), male sex (p\&nbsp;=\&nbsp;.036), higher risk group (p\&nbsp;=\&nbsp;.025), and cranial radiation (p\&nbsp;=\&nbsp;.004). Cataract was associated with decreased visual acuity. CONCLUSIONS: OA at diagnosis, present in 12\% of patients, were associated with older age, anemia, and thrombocytopenia and did not carry a significant prognostic impact. Cataracts were detected in over 10\% of patients and were associated with decreased visual acuity, thus supporting routine screening after completion of therapy, especially for those treated with high-risk protocols.},
	issn = {1545-5017},
	doi = {10.1002/pbc.29542},
	author = {Gotti, Giacomo and Stevenson, Kristen and Kay-Green, Samantha and Blonquist, Traci M and Mantagos, Jason S and Silverman, Lewis B and Place, Andrew E}
}
