title: Cytomegalovirus retinitis as an adverse immunological effect of pulses of vincristine and dexamethasone in maintenance therapy for childhood acute lymphoblastic leukemia.
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.
authors.affiliation: Faculty of Medicine, Division of Pediatrics, Department of Reproductive and Developmental Medicine, University of Miyazaki, Miyazaki, Japan. moritake@fc.miyazaki-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Moritake
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Kamimura
authors.forename: Hitomi
authors.initials: H
authors.lastname: Kojima
authors.forename: Hidemi
authors.initials: H
authors.lastname: Shimonodan
authors.forename: Masako
authors.initials: M
authors.lastname: Harada
authors.forename: Takako
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Nao-I
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nunoi
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002675:Child, Preschool; D017726:Cytomegalovirus Retinitis / Q000139:chemically induced*; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D060046:Maintenance Chemotherapy / Q000009:adverse effects* / Q000379:methods; D015122:Mercaptopurine / Q000008:administration & dosage / Q000009:adverse effects; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D014750:Vincristine; D003907:Dexamethasone; D015122:Mercaptopurine; D008727:Methotrexate