Retinal abnormalities in newly diagnosed adult acute myeloid leukemia

Retinal abnormalities (RA) are very frequently observed in adult patients w ith acute myeloid leukemia (AML), but the clinical significance of these fi ndings has not been fully investigated. We examined the fundus oculi in a c ohort of 122 adult patients with AML at presentation and analyzed some clin ical and biological features to assess whether there was any association wi th RA. For this purpose, we subdivided the patients into two groups accordi ng to the presence or absence of RA (groups 1 and 2, respectively). We cons idered current laboratory parameters such as white blood cell (WBC) count, hemoglobin (Hb), platelets and serum lactate dehydrogenase (LDH). Moreover, we subdivided the patients into two groups according to age <60 (group A) or <greater than or equal to>60 years (group B) to evaluate a possible asso ciation between RA and response to treatment and/or overall survival (OS). In our series, a higher median age and a lower Hb value were associated wit h group 1 (p = 0.001 and p = 0.04, respectively); the median LDH value was 812 U/I (range 224-5,551) and 607 (range 181-5,244) for groups 1 and 2, res pectively (p = 0.02). There was no association between RA and karyotypic al terations. In terms of outcome, in group A (<60 years), 80% patients who ac hieved complete remission (CR) were in group 2 vs. 13% nonresponders (NR) ( p < 0.0001). Median OS of group 2 patients was 49.7 months compared with 7. 2 months for those in group 1 (p = 0.002). In group B, 58% patients who ach ieved CR were in group 1 vs. 15% NR (p < 0.006). Median OS of patients in g roup 2 was 14.6 months compared with 2.9 months in group 1 (p = 0.02). Our data show that RA are significantly associated with some biological feature s and with shorter OS in AML patients and this parameter seems to be an eff ective clinical sign of poor prognosis in terms of CR. Copyright (C) 2001 S . Karger AG, Basel.