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H. Oohashi, K. Kawai; Visual Outcome in Long-Term Survival Patients With Bone Marrow Transplantation Due to Hematological Malignancies in Childhood. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6008.
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To evaluate ocular complications in long-term survival patients with bone marrow transplantation(BMT) due to hematological malignancies in childhood.
Cross-sectional study.This study examined 53 patients done BMT in childhood from 1982 to 1999 because of hematological malignancies. All patients have been treated in Tokai University School of Medicine. 19 patients had Acute Lymphocytic Leukemia(ALL), 10 had Aplastic Anemia(AA), 5 had Acute Myelogenous Leukemia(AML), 4 had Chronic Myelogenous Leukemia(CML), 15 had other diseases. All patients had been conditioned with allogeneic BMT(alloBMT). Their pre-alloBMT conditioning regimens were f-TBI(fractionated total body irradiation) or f-TAI(fractionated thoraco-abdominal irradiation) or chemotherapy. The mean follow-up time was 17.0(±4.1) years. Ocular examinations were performed monthly at first, now yearly.
15 patients(28.3%) had dry eye, 1 patient(2%) had corneal ulcer, 1 patient(2%) had uveitis, and 26 patients(49.1%) had cataract. 44 patients(83.0%) had one or two ocular complications. Any pre-BMT conditioning regimen had not influenced dry eye(p>0.5). And steroid therapy and graft versus host disease(GVHD) had not influenced dry eye(p>0.4). While f-TBI had influenced cataract formation(cf)(p<0.001). Acute GVHD(grade2 and 3) had influenced cf(p<0.02). Chronic GVHD had not influenced cf (p>0.05). Steroid therapy had not influenced cf(p>0.3).No patients had done special therapy including surgical intervention. Now, visual acuity of 51 patients(96.2%) is above 20/20.
This study suggests that long-term suvival patients done BMT in childhood don't necessarily have severe ocular complications and their quality of vision is as good as ordinary people.
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