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JAMA Oncology Clinical Challenge
October 2015

Blurred Vision

Author Affiliations
  • 1Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
  • 2Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
  • 3Section of Ophthalmology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
JAMA Oncol. 2015;1(7):979-980. doi:10.1001/jamaoncol.2015.2297

A man in his 70s presented with blurred vision in his left eye. The patient had a history of myelodysplastic syndrome (refractory anemia with excess blasts–2), prostate cancer treated with prostatectomy and radiation therapy 5 years prior, and colonic adenocarcinoma treated with right hemicolectomy 6 years prior. Four months before presentation, his myelodysplastic syndrome transformed into acute myeloid leukemia (AML). He was randomized to experimental drug CPX-351 for induction, but treatment was discontinued as a result of renal failure. However, remission was successfully induced with mitoxantrone hydrochloride and etoposide therapy, as confirmed by bone marrow biopsy, and he was prescribed continuing melphalan therapy on an outpatient basis.

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