Summary
A 49-year-old man with chronic myelogenous leukemia developed dense posterior subcapsular cataracts and punctate cortical opacities after five years of busulfan (Myleran) therapy.
We found that the histopathologic appearance of busulfan-induced cataracts is similar to other forms of human and experimental cataracts, regardless of cause. Ultrastructural examination revealed cortical liquefaction with formation of Morgagnian droplets, involving primarily the region from the equator to the posterior subcapsular space. In contrast to previous findings in rats, we observed posterior migration of equatorial nuclei and bladder cell formation. Also present were socalled crystalloid rays and abundant degenerate lens fiber membranes manifested as multi-layered, irregularly folded configurations resembling myelin figures.
Zusammenfassung
Bei einem 49-jährigen Mann mit chronischer myelogener Leukämie zeigten sich nach fünfjähriger Behandlung mit Busulfan (Myleran) dichte, hintere subkapsuläre Katarakte mit punktförmiger Rindentrübung.
Das histologische Bild dieser Busulfankatarakte ähnelte dem anderer menschlicher und experimenteller Katarakte, was auch immer deren Ursache ist. Elektronenmikroskopische Untersuchungen zeigten, eine Verflüssigung der Linsenrinde mit Morgagnischer Tropfenbildung. Diese Veränderungen fanden sich hauptsächlich in der Region zwischen Äquator und hinterem Linsenpol. Im Gegensatz zu früheren Beschreibungen von Rattenkatarakten zeigte sich eine Proliferation der hinteren Linsenepithelkerne mit der Bildung von Blasenzellen. Wir fanden auch sogenannte kristallähnliche Strahlen (geometrisch reguläre Körnchen) und reichlich entartete Linsenfasermembranen, die sich als vielschichtige, unregelmäßig gefaltete, dem Myelin ähnelnde Formen manifestieren.
Similar content being viewed by others
References
Cotlier, E., Apple, D.J.: Cataracts induced by the polypeptide antibiotic polymyxin B sulfate. Exp Eye res 16, 69–77 (1973)
Cotlier, E., Sanders, D., Wyhinny, G.: Effects of cetylpyridinium chloride on the membranes of the lens fibers and on lens permeability, hydration, and 22Na and 86Rb transport. Ophthalmic Res 6, 107–130 (1974)
Dahlgren, S., Holm, G., Svanborg, N., Watz, R.: Clinical and morphological side-effects of busulfan (myleran) treatment. Acta Med Scand 192, 129–135 (1972)
Galton, D.A.G.: Myleran in chronic myeloid leukemia: Results of treatment. Lancet 1953 I, 208–213
Grimes, P., von Sallmann, L., Frichette, A.: Influence of Myleran on cell proliferation in the lens epithelium. Invest Ophthalmol 3, 566–576 (1964)
Grimes, P., von Sallmann, L.: Interference with cell proliferation and induction of polyploidy in rat lens epithelium during prolonged Myleran treatment. Exp Cell Res 42, 265–273 (1966)
Kandori, F., Kurimoto, S.: An experimental study on the chronic toxicity of Myleran and its influence upon the lens, endocrine glands, and internal organs of rats. Acta Pathol Jap 10, 35–45 (1960)
Kurimoto, S.: Studies upon the experimental cataracts: I. Myleran cataract and its toxicity to the endocrine glands and internal organs. Yonaga Acta Medica 3, 174–180 (1959)
Peyman, G.A., May, D.R., Ericson, E.S., Apple, D.J.: Intraocular injection of gentamicin: Toxic effects and clearance. Arch Ophthalmol 92, 42–47 (1974)
Podos, S.M., Canellos, G.P.: Lens changes in chronic granulocytic leukemia. Am. J. Ophthalmol. 68, 500–504 (1969)
Ravindranathan, M.P., Paul, V.J., Kuriakose, E.T.: Cataract after busulfan treatment. Br. Med. J. 1972 I, 218–219
von Sallmann, L.: The lens epithelium in the pathogenesis of cataract. Am. J. Ophthalmol. 44, 159–170 (1957)
Smalley, R.V., Wall, R.L.: Two cases of busulfan toxicity. Ann Intern Med 64, 154–164 (1966)
Solomon, C., Light, A.E., DeBeer, E.J.: Cataracts produced in rats by 1,4-dimethanesulfonoxy-butane (Myleran). Arch Ophthalmol 54, 850–852 (1955)
Author information
Authors and Affiliations
Additional information
Presented in part at the annual meeting of the Association for Research in Vision and Ophthalmology, Central Division, Chicago, Nov. 1, 2, 1974.
Rights and permissions
About this article
Cite this article
Hamming, N.A., Apple, D.J. & Goldberg, M.F. Histopathology and ultrastructure of busulfan-induced cataract. Albrecht von Graefes Arch. Klin. Ophthalmol. 200, 139–147 (1976). https://doi.org/10.1007/BF00414363
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00414363