PROGNOSTIC-SIGNIFICANCE OF RETINOPATHY AT PRESENTATION IN ADULT ACUTE-LEUKEMIA

Retinal changes are common in adult acute leukemia patients at present ation, but their prognostic significance is controversial, A 5-year st udy has been carried out with newly diagnosed acute leukemia patients aged 12-77 years, Seventy-seven cases (49 AML, 28 ALL) were studied pr ospectively for the presence of intraretinal hemorrhages (IRH), white- centered hemorrhages, cotton-wool spots, and macular hemorrhages. They were treated according to standard chemotherapy protocols, and then a chievement of complete remission (CR) and the duration of overall surv ival (OS) were compared between the groups with and without these diff erent retinal features, No association was found between the presence of any retinal abnormality and CR induction rate, although there was a trend to a lower CR rate among patients with IRH. The median OS of th ose with IRH was 72 days, compared with 345 days among those without I RH (p=0.002), A WBC at presentation greater than 50x10(9)/l and age gr eater than 40 years were also associated with shorter OS (p<0.0001 and p=0.0045, respectively). However, after regression analysis, IRH rema ined statistically significant as a poor prognostic indicator (p=0.01) .) We conclude that the presence of IRH is an indicator of poor progno sis in acute leukemia.