Vision loss as the first manifestation of isolated cns relapse in CML blast crisis during flumatinib maintenance therapy: A case report.
Lili Hong, Jie Mu, Kaiqian Yang et al.
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Case in brief
A 65-year-old male with chronic myeloid leukemia in complete remission presented with progressive vision loss, indicating isolated CNS relapse. Despite prophylactic intrathecal chemotherapy, cerebrospinal fluid analysis revealed blast cells, confirming the diagnosis. The patient was treated with intrathecal and systemic high-dose chemotherapy alongside tyrosine kinase inhibitors, resulting in visual recovery and sustained remission at 14 months.
Diagnostic / clinical pearl
Clinicians should maintain a high index of suspicion for CNS relapse in leukemia patients presenting with atypical symptoms like vision loss, even in the absence of neurological signs.
Why it matters
This case highlights the need for thorough evaluation of ocular symptoms in hematologic malignancies, as they may indicate serious underlying complications.