PRIMARY OCULAR RELAPSE IN ACUTE LYMPHOBLASTIC-LEUKEMIA

Relapse of acute lymphoblastic leukaemia (ALL) occurred in the anterio r segment of four children. All cases had been treated according to th e Medical Research Council's UK Acute Lymphoblastic Leukaemia trial pr otocol (UKALL) including 2 years of continuation chemotherapy. In thre e cases the diagnosis was confirmed by anterior chamber aspirate while in one case the diagnosis was presumed on clinical grounds alone. All four cases experienced isolated leukaemic relapse in the anterior seg ment within 2 months of stopping therapy. The months immediately follo wing cessation of continuation chemotherapy as part of the UKALL regim e appear to represent a 'high-risk' period for primary anterior segmen t relapse of ALL. Children with ALL presenting with uveitis should be regarded as having leukaemic relapse and anterior chamber taps with or without an iris biopsy should be considered to confirm this diagnosis . Early diagnosis and treatment of ocular leukaemic relapse is likely to give these children the best chance of ultimate cure.