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Cytomegalovirus retinitis as an adverse immunological effect of pulses of vincristine and dexamethasone in maintenance therapy for childhood acute lymphoblastic leukemia

Authors

  • Hiroshi Moritake MD, PhD,

    Corresponding author
    1. Faculty of Medicine, Division of Pediatrics, Department of Reproductive and Developmental Medicine, University of Miyazaki, Miyazaki, Japan
    • Faculty of Medicine, Division of Pediatrics, Department of Reproductive and Developmental Medicine, University of Miyazaki, Miyazaki 889-1692.===

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  • Sachiyo Kamimura MD,

    1. Faculty of Medicine, Division of Pediatrics, Department of Reproductive and Developmental Medicine, University of Miyazaki, Miyazaki, Japan
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  • Hitomi Kojima MD,

    1. Faculty of Medicine, Division of Pediatrics, Department of Reproductive and Developmental Medicine, University of Miyazaki, Miyazaki, Japan
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  • Hidemi Shimonodan MD,

    1. Faculty of Medicine, Division of Pediatrics, Department of Reproductive and Developmental Medicine, University of Miyazaki, Miyazaki, Japan
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  • Masako Harada MD,

    1. Faculty of Medicine, Division of Pediatrics, Department of Reproductive and Developmental Medicine, University of Miyazaki, Miyazaki, Japan
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  • Takako Sugimoto MD,

    1. Faculty of Medicine, Department of Ophthalmology, University of Miyazaki, Miyazaki, Japan
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  • Nobuhisa Nao-i MD, PhD,

    1. Faculty of Medicine, Department of Ophthalmology, University of Miyazaki, Miyazaki, Japan
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  • Hiroyuki Nunoi MD, PhD

    1. Faculty of Medicine, Division of Pediatrics, Department of Reproductive and Developmental Medicine, University of Miyazaki, Miyazaki, Japan
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  • Conflict of interest: Nothing to declare.

Abstract

We describe a 5-year-old female with acute lymphoblastic leukemia (ALL) who suffered from cytomegalovirus (CMV) retinitis during maintenance therapy consisting of 6-mercaptopurine (6-MP) and methotrexate (MTX) with pulses of vincristine (VCR) and dexamethasone (DEX). Administration of anticytomegaloviral drugs led to a complete regression of active retinitis. Her low CD4 positive T cells and serum immunoglobulin G (IgG) recovered when maintenance therapy was resumed without VCR and DEX. The patient has been in complete remission (CR) for more than 5 months after completion of maintenance therapy without recurrence of CMV retinitis. Pediatr Blood Cancer 2013;60:329–331. © 2012 Wiley Periodicals, Inc.

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