December 8, 2025BloodOpen Access

Bilateral optic nerve infiltration in pediatric ACUTE promyelocytic leukemia: A RARE and aggressive CNS relapse with probable ATRA resistance

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Discussion

Case report reveals ATRA resistance and CNS involvement in pediatric acute promyelocytic leukemia, highlighting the need for alternative therapies.

Treatment failure observed with persistent leukemic blasts in the cerebrospinal fluid, indicating a severe CNS relapse.
Patient suffered visual loss, diagnosed with bilateral optic nerve infiltration detected via MRI and CSF cytometry.
Reinduction therapy using arsenic trioxide and intrathecal chemotherapy was initiated following a confirmed bone marrow relapse.
Case emphasizes the critical need for vigilant monitoring and alternative strategies in managing refractory pediatric acute promyelocytic leukemia.

Ron et al. (2025) studied this question.

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Case report reveals ATRA resistance and CNS involvement in pediatric acute promyelocytic leukemia, highlighting the need for alternative therapies.