We present a case of juvenile myelomonocytic leukemia (JMML) with ocular infiltration. A 1-month-old boy presented with myeloid
precursors in peripheral blood and a white blood cell count 1 10×10
9/l. His peripheral blood monocyte count was 1 1×10
9/l, bone marrow blasts were <20%, and no Ph chromosome was identified. The boy also presented with hepatosplenomegaly, pallor,
fever, and skin rash. We diagnosed this case as JMML, although hemoglobin F was within the normal range and no spontaneous
colony growth was observed from peripheral blood mononuclear cells. Neither Epstein-Barr (EB) virus nor cytomegalovirus was
detected by PCR in bone marrow aspirate or peripheral blood. The patient had several lesions into which JMML cells might have
infiltrated, including skin, liver, spleen, oral cavity, right lung, sigmoid colon, and both eyes. To our knowledge, this
is the first reported case of JMML with ocular involvement. Since infiltration of JMML cells into both eyes causes blindness,
further consideration of the timing of bone marrow transplantation (BMT) in JMML is necessary.
Key words Juvenile myelomonocytic leukemia - Ocular infiltration - Bone marrow transplantation
Received: February 17, 1999 / Accepted: June 21, 1999