Ophthalmic manifestations of haematological disorders

Five case histories are presented. Waldenstrom's macroglobulinaemia caused bilateral central retinal vein occlusion, proptosis was the presenting feature of retro-orbital plasmacytoma in relapsed multiple myeloma, a red painful eye was due to neovascular glaucoma in primary polycythaemia, bilateral VIth nerve palsy caused convergent squint and diplopia in meningeal relapse of acute lymphoblastic leukaemia and lymphoma of the eyelid caused complete ptosis. Interdisciplinary management is described. Ophthalmological lesions in haematological disease should be promptly recognized and managed. Collaboration between ophthalmology and haematology departments may be effective for palliative management.

Five-year follow-up of patients treated with imatinib mesylate for chronic myeloid leukaemia in Trinidad and Tobago

OBJECTIVE

Data on the use of Imatinib (IM) in developing countries remain limited. A retrospective study was done to assess the efficacy and toxicity of IM in treating chronic myeloid leukaemia (CML) in Trinidad and Tobago.

METHODS

Patients in all phases of CML who started IM therapy between February 2001 and February 2004 were included. All had received other previous therapy. They were assessed for haematological, cytogenetic and molecular response, overall survival (OS), event free survival (EFS) and adverse effects (AE).

RESULTS

Twenty-five patients were followed-up for a median 61 months. At initiation of IM, 18 were in the chronic phase (CP), 3 in accelerated phase (AP), 3 in blast crisis (BC) and one in myelofibrotic transformation (MF). Overall, 96% of patients achieved complete haematological remission (CHR). Among CP patients, 67% attained a major cytogenetic response (MCR) and 44% a complete cytogenetic response (CCR). Overall survival and event free survival in the CP group were 82% and 76% respectively. Overall survival for advanced phase patients was 14% at 61 months. The adverse effects of IM were the same as previously described and generally tolerable. No patient opted to discontinue IM because of side effects.

CONCLUSION

After 5 years of follow-up, IM was found to induce favourable and durable survival responses with an acceptable side effect profile in CP-CML patients who had received prior treatment with alternative agents.