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AMG 330, a bispecific T-cell engager (BiTE®) that binds CD33 and CD3 on T cells facilitates T-cell–mediated cytotoxicity against CD33+ cells. This first-in-human, open-label, dose-escalation study evaluated the safety, pharmacokinetics, pharmacodynamics, and preliminary efficacy of AMG 330 in adults with relapsed/refractory acute myeloid leukemia (R/R AML). Amongst 77 patients treated with AMG 330 (0.5 µg/day–1.6 mg/day) on 14-day or 28-day cycles, maximum tolerated dose was not reached; median duration of treatment was 29 days. The most frequent treatment-related adverse events were cytokine release syndrome (CRS; 78%) and rash (30%); 10% of patients experienced grade 3/4 CRS. CRS was mitigated with stepwise dosing of AMG 330, prophylactic dexamethasone, and early treatment with tocilizumab. Among 60 evaluable patients, eight achieved complete remission or morphologic leukemia-free state; of the 52 non-responders, 37% had ≥50% reduction in AML bone marrow blasts. AMG 330 is a promising CD33-targeted therapeutic strategy for R/R AML. [ABSTRACT FROM AUTHOR]

There is mounting evidence to support the use of ruxolitinib earlier in the disease course of myelofibrosis. Use in intermediate‐1 risk myelofibrosis is generally associated with higher efficacy and lower toxicity. [ABSTRACT FROM AUTHOR]

Key Points: Question: Is frontline ponatinib superior to imatinib when combined with reduced-intensity chemotherapy in adults with newly diagnosed Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL)? Findings: In this randomized clinical trial, ponatinib demonstrated a significantly higher minimal residual disease–negative complete remission rate at the end of induction (34.4% vs 16.7% with imatinib) and a comparable safety profile vs imatinib when combined with reduced-intensity chemotherapy in adults with newly diagnosed Ph+ ALL. Meaning: These efficacy and safety results support consideration of ponatinib as a frontline tyrosine kinase inhibitor in combination with chemotherapy for adults with newly diagnosed Ph+ ALL. Importance: In newly diagnosed Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL), disease progression due to acquired resistance to first- or second-generation BCR::ABL1 tyrosine kinase inhibitors is common. Ponatinib inhibits BCR::ABL1 and all single-mutation variants, including T315I. Objective: To compare frontline ponatinib vs imatinib in adults with newly diagnosed Ph+ ALL. Design, Setting, and Participants: Global registrational, phase 3, open-label trial in adults aged 18 years or older with newly diagnosed Ph+ ALL. From January 2019 to May 2022, eligible patients at 77 sites were randomized 2:1 to ponatinib (30 mg/d) or imatinib (600 mg/d) with reduced-intensity chemotherapy, followed by single-agent ponatinib or imatinib after the cycle 20 phase of the trial. The last date of follow-up for this analysis was August 12, 2022. Intervention: Patients received ponatinib, 30 mg/d, or imatinib, 600 mg/d, with reduced-intensity chemotherapy, followed by single-agent ponatinib or imatinib after cycle 20. The ponatinib dose was reduced to 15 mg on achievement of minimal residual disease–(MRD) negative complete remission. Main Outcomes and Measures: The primary end point of this interim analysis was MRD-negative complete remission (≤0.01% BCR::ABL1 [MR4] centrally assessed by reverse transcriptase–quantitative polymerase chain reaction), with complete remission maintained for at least 4 weeks at the end of cycle 3. The key secondary end point was event-free survival. Results: Of 245 patients randomized (median age, 54 years; 133 [54.3%] female), 232 (ponatinib, n = 154; imatinib, n = 78) who had p190 or p210 dominant isoforms verified by the central laboratory were analyzed for the primary end point. The MRD-negative complete remission rate (primary end point) was significantly higher with ponatinib (34.4% [53/154]) vs imatinib (16.7% [13/78]) (risk difference, 0.18 [95% CI, 0.06-0.29]; P =.002). At the data cutoff, event-free survival had not met the prespecified number of events. Median event-free survival was not reached in the ponatinib group and was 29 months in the imatinib group. The most common adverse events were similar between treatment groups. Arterial occlusive events were infrequent and comparable between groups (ponatinib, 2.5%; imatinib, 1.2%). Conclusions and Relevance: Ponatinib demonstrated a superior rate of MRD-negative complete remission at the end of induction vs imatinib when combined with reduced-intensity chemotherapy in adults with newly diagnosed Ph+ ALL. The safety profile of ponatinib was comparable with imatinib. Trial Registration: ClinicalTrials.gov Identifier: NCT03589326 This randomized trial assesses the effect of ponatinib vs imatinib combined with low-intensity chemotherapy on disease remission in adults with newly diagnosed Philadelphia chromosome–positive acute lymphoblastic leukemia (ALL). [ABSTRACT FROM AUTHOR]

Significant variations exist related to the end of induction practices in the management of Acute Promyelocytic Leukemia (APL). These variations include all-trans retinoic acid (ATRA)-arsenic trioxide (ATO) in fixed doses versus continuation until hematologic complete remission (CR) and performance versus omission of post-induction bone marrow biopsy to confirm morphological CR. A retrospective chart review was conducted of 61 patients (42 low/intermediate-risk and 19 high-risk) aged ≥ 18 years with newly diagnosed APL treated with fixed duration ATRA-ATO +/- cytoreduction at a tertiary medical center from December 2012 through March 2020. Of the 54 patients with post-induction bone marrow biopsy results, 52 (96%) demonstrated no morphologic evidence of APL while the remaining were equivocal. After 2.6 years median follow-up, no relapses occurred. The estimated 2-year overall survival rate of 95% suggests excellent outcomes with a fixed ATO induction regimen and safe omission of post-induction bone marrow biopsy irrespective of hematologic parameters. [ABSTRACT FROM AUTHOR]

Background: This retrospective cohort study used an electronic health record‐derived, de‐identified, US patient‐level database to better understand the real‐world treatment experience, in a predominantly community setting (80.3% of patients), of venetoclax+hypomethylating agents (HMAs) in routine clinical care, pre‐ and post‐VIALE‐A, to determine whether the post‐remission cytopenia management insight from VIALE‐A was reflected in real‐world clinical practice. Methods: Patients with newly diagnosed acute myeloid leukemia (AML; N = 498), who initiated venetoclax+HMA ≤30 days from AML diagnosis from June 1, 2018, to March 31, 2021, were stratified into pre‐(n = 330) and post‐(n = 168) VIALE‐A cohorts. Results: More patients in the post‐(61%) versus pre‐(45%) VIALE‐A cohort had their first biopsy by 28 ± 14 days post‐treatment initiation. Patients underwent bone marrow (BM) assessment earlier in the post‐ versus pre‐VIALE‐A cohort, and first identification of response was also earlier (2.5 vs 5.1 months, respectively). More venetoclax schedule modifications post‐remission occurred among post‐(82.1%) versus pre‐(73.8%) VIALE‐A responders; the most common reason for modification was treatment toxicities, specifically cytopenia. Treatment survival outcomes were comparable with or without venetoclax schedule modifications. Conclusions: Findings suggest that venetoclax schedule modifications can be used to manage cytopenia events without adversely affecting outcomes. Opportunities remain to improve earlier BM assessment to determine venetoclax schedule modifications, providing the best chance for optimal treatment outcomes. [ABSTRACT FROM AUTHOR]

Cytopenic myelofibrosis is increasingly recognized as a phenotype of myelofibrosis presenting with low blood counts, lower driver mutation allele burden, increased likelihood of arising de novo, i.e. primary myelofibrosis, greater genomic complexity, worse survival, and higher rates of leukemic transformation compared to the more traditional 'myeloproliferative' phenotype. Both anemia and thrombocytopenia are very common, often coexist, and can be worsened by treatment. Several JAK inhibitors with different kinome profiles are now available for routine clinical use. Additionally, ancillary therapies can also provide some, albeit non-durable, benefit. In this review, we discuss the prevalence and clinical significance of cytopenias in myelofibrosis. We then discuss the various Janus kinase (JAK) inhibitors and ancillary therapies available with a special focus on their use in cytopenic populations, ability to improve cytopenias, and notable adverse events. Articles included were selected through literature searches using the PubMed database. Pacritinib and momelotinib are new treatment options for patients with cytopenic myelofibrosis. These JAK inhibitors are less myelosuppressive and allow for cytopenia stabilization or improvement while providing additional benefits. It is likely that their use will expand and these newer JAK inhibitors will become backbones for future combinations with novel, 'disease modifying' agents. [ABSTRACT FROM AUTHOR]

Patients who received treatment after HMA/Ven failure had longer median OS compared to patients who did not receive additional therapy ( I n i = 17, 4.7 vs 1.7 months, HR = 0.29, 95% CI 0.13-0.62, I p i = 0.0017) (Figure 1(C)). The combination of Venetoclax (Ven) with hypomethylating agents (HMA/Ven) is the standard-of-care therapy for patients with newly diagnosed (ND) acute myeloid leukemia (AML) who are >= 75 years of age or have comorbidities that preclude the use of intensive chemotherapy (IC). A second study that assessed outcomes of patients after failure of salvage HMA/Ven found a somewhat longer median OS of 3.9 months; however, the median age of that cohort was younger, and a larger portion of those patients received treatment following HMA/Ven failure [[8]]. We report median OS in patients receiving additional therapy to be 4.7 months, which is comparable to that reported for R/R AML (4.3 months) and slightly longer than the median OS reported for patients receiving salvage therapy following frontline HMA/Ven failure (2.9 months) [[7]]. [Extracted from the article]

Philadelphia chromosome positive (Ph+) B cell acute lymphoblastic leukemia (ALL) is extremely rare in pregnancy. Although the use of tyrosine kinase inhibitors (TKIs) has significantly improved outcomes of patients with Ph+ ALL, its use during pregnancy is not recommended due to the risk of fetal malformations. There are limited data on the use of TKIs during pregnancy and its long-term effects on the fetus. Within this context, we present a case of a 25-year-old woman diagnosed with Ph+ ALL during the third trimester and the safe and effective use of imatinib as treatment after failure of conventional chemotherapy. [ABSTRACT FROM AUTHOR]

Background Treatment with venetoclax + hypomethylating agents (HMAs) is standard-of-care for newly diagnosed (ND) patients with acute myeloid leukemia (AML) aged ≥75 years, or with comorbidities precluding intensive chemotherapy. We describe real-world venetoclax + HMA treatment practices and outcomes in patients with ND AML in the US. Patients and Methods This retrospective cohort study used an electronic health record-derived, US nationwide, de-identified database, and included adults with ND AML, initiating venetoclax + HMA treatment ≤30 days from diagnosis (June 1, 2018-January 31, 2020). Venetoclax treatment variables included dosing information, schedule modifications, and drug–drug interactions. The median venetoclax + HMA treatment duration and overall survival (OS) from venetoclax initiation to discontinuation, death, or end of follow-up (August 31, 2020) were examined by Kaplan-Meier analyses. Results Overall, 169 patients were included. The median age at diagnosis was 77 years; 85.2% of patients were treated in community practice. Ninety-five of 169 patients (56.2%) had evaluable bone marrow response data following the start of treatment; 53.7% were assessed approximately at the end of cycle 1. Following the first treatment cycle, treatment schedule modifications were recorded in 101 patients and dose changes in 56, primarily due to toxicity. The median treatment duration was 5.2 months; the median OS was 8.6 months (median follow-up was 7.2 months). Venetoclax dose changes did not modify efficacy outcomes, but longer median OS was associated with venetoclax treatment schedule modifications (P =.02). Conclusions This study reflects early real-world experience with venetoclax + HMAs in a predominantly community setting and emphasizes the importance of appropriate venetoclax management in optimizing patient outcomes. [ABSTRACT FROM AUTHOR]

Opinion statement: The coronavirus disease-19 (COVID-19) pandemic has posed numerous challenges to the global healthcare system. Of particular gravity is adult and pediatric patients with hematologic malignancies who are among the most vulnerable groups of patients at risk of severe COVID-19 outcomes. In the early phases of the pandemic, several treatment modifications were proposed for patients with leukemia. Largely speaking, these were adopting less-intense therapies and more utilization of the outpatient setting. Over time, our understanding and management have become more nuanced. Furthermore, equipped with vaccinations to prevent COVID-19 infection and availability of treatments in the presence of COVID-19 infection, the recommendations on management of patients with leukemia have evolved. Patient's leukemia characteristics, possibility of targeted therapy, vaccination status, symptomatology, comorbidities, goal of anti-leukemic therapy, the intensity of therapy, the setting of treatment, as well as loco regional factors like dynamic incidence of COVID-19 in the community and hospital/ICU bed status are among many factors that influence the decisions. Furthermore, the oncology community has adopted delaying the anti-leukemia therapy for a limited time frame, if clinically possible, so as to still deliver most appropriate therapy while minimizing risks. Early adoption of growth factor support and conservative blood transfusion practices have helped as well. In this review, we discuss the impact of COVID-19 on outcomes and share considerations for treatments of leukemias. We describe the impact on both clinical care (from diagnosis to treatment) and research, and cover the literature on vaccines and treatments for COVID-19 in relation to leukemia. [ABSTRACT FROM AUTHOR]

Venetoclax (Ven), combined with hypomethylating agents (HMA) such as azacitadine (Aza) or decitabine (Dec), is approved as front-line treatment for elderly or unfit patients with AML.3 HMA/Ven is now also being used frequently in the salvage setting. All patients in the IC cohort received a high-dose cytarabine-based regimen [fludarabine, cytarabine, granulocyte colony-stimulating factor (FLAG) = 16; FLAG with idarubicin (FLAG-ida) = 2; cladribine, cytarabine, granulocyte colony-stimulating factor, mitoxantrone (CLAG-M) = 6]. The only other study comparing HMA/Ven to IC for r/r AML utilized 10 days of Dec, instead of five, with the initial IC regimens already incorporating high-dose cytarabine plus an anthracycline with or without purine analogues. [Extracted from the article]

Tyrosine kinase inhibitors (TKIs) of the BCR-ABL fusion protein have dramatically changed the mortality of chronic myeloid leukemia (CML) but they carry a risk of serious vascular morbidity. While TKIs do not cure CML, daily oral administration of a TKI can control CML and TKIs are chronic medications. Interestingly, vascular complications can occur at any time a patient is on a TKI. Therefore, it is imperative that all care team members and patients are aware of and watching for possible vascular complications. In the following review, a case of arterial thrombosis secondary to the TKI ponatinib is presented as well as a discussion of thrombotic and vascular adverse events reported with TKIs. TKIs are metabolized through the cytochrome P450 system and important drug interactions to consider are reviewed. Finally, we present a multidisciplinary approach to the management of patients with CML on TKIs. [ABSTRACT FROM AUTHOR]

The development of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of patients with advanced stage cancers. However, immune-related adverse events are frequently observed. Cardiac toxicity from ICI therapy can range from asymptomatic troponin-I elevations to conduction abnormalities of the heart and even fulminant myocarditis. Although rare, myocarditis is a potentially fatal adverse effect of ICI therapy. We present a series of five cases of ICI-related cardio-toxicity diagnosed and managed at Roswell Park Comprehensive Cancer Center along with a review of published case reports in the literature. Our series highlights the importance of high clinical suspicion, early diagnosis of myocarditis, and prompt initiation of immunosuppressive therapy. [ABSTRACT FROM AUTHOR]

Acquired thrombotic thrombocytopenic purpura (TTP) is characterized by autoantibodies against a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13). Uncleaved von Willebrand factor (VWF) multimers accumulate and bind to platelets which causes spontaneous microthrombi ultimately causing microangiopathic hemolytic anemia, thrombocytopenia, and end-organ ischemia. Plasma exchange (PEX) with or without steroids constitutes standard first-line therapy with rituximab typically reserved for refractory cases. Therapies beyond rituximab lack strong evidence for routine use. Recently, bortezomib, a proteasome inhibitor used commonly in patients with multiple myeloma, was shown to induce remission in patients with refractory TTP. Here, we report a case of severe, relapsed TTP that was refractory to PEX, steroids, and rituximab that underwent remission following three cycles of bortezomib. We discuss the salient features of our case, the mechanism of action of bortezomib, and the very few other similar reports that exist in the literature. We conclude that bortezomib should be considered for patients with TTP refractory to PEX, steroids, and rituximab due to its efficacy and relatively favorable side effect profile. [ABSTRACT FROM AUTHOR]

Opinion Statement: Approximately 40-45% of younger and 10-20% of older adults with acute myeloid leukemia (AML) will be cured with current standard chemotherapy. The outlook is particularly gloomy for patients with relapsed and/or refractory disease (cure rates no higher than 10%). Allogeneic hematopoietic stem cell transplantation (HSCT), the only realistic hope of cure for these patients, is an option for only a minority. In recent years, much has been learned about the genomic and epigenomic landscapes of AML, and the clonal architecture of both de novo and secondary AML has begun to be unraveled. These advances have paved the way for rational drug development as new "drugable" targets have emerged. Although no new drug has been approved for AML in over four decades, with the exception of gemtuzumab ozogamycin, which was subsequently withdrawn, there is progress on the horizon with the possible regulatory approval soon of agents such as CPX-351 and midostaurin, the Food and Drug Administration "breakthrough" designation granted to venetoclax, and promising agents such as the IDH inhibitors AG-221 and AG-120, the smoothened inhibitor glasdegib and the histone deacetylase inhibitor pracinostat. In our practice, we treat most patients with relapsed/refractory AML on clinical trials, taking into consideration their prior treatment history and response to the same. We utilize targeted sequencing of genes frequently mutated in AML to identify "actionable" mutations, e.g., in FLT3 or IDH1/2, and incorporate small-molecule inhibitors of these oncogenic kinases into our therapeutic regimens whenever possible. In the absence of actionable mutations, we rationally combine conventional agents with other novel therapies such as monoclonal antibodies and other targeted drugs. For fit patients up to the age of 65, we often use high-dose cytarabine-containing backbone regimens. For older or unfit patients, we prefer hypomethylating agent-based therapy. Finally, all patients with relapsed/refractory AML are evaluated for allogeneic HSCT. [ABSTRACT FROM AUTHOR]

The article offers information on a study related to radiological imaging and bone marrow biopsy in staging of cutaneous B-cell lymphoma. It notes that B-lymphocyte derived lymphoma develops in skin without any extracutaneous involvement at the time of diagnosis. It mentions several symptoms including fatigue, evolution of multiple lesions over a few months, and swelling in neck.

Spontaneous remission (SR) of acute myeloid leukemia (AML) is a very rare phenomenon. AML characterized by FLT3 internal tandem duplication (FLT3 ITD) is typically associated with an aggressive clinical course with rapid progression, relapse, and short overall survival in the absence of transplantation. We report here the first case of SR of FLT3 ITD mutant AML in the literature. Our patient was an elderly woman with relapsed NPM1 and FLT3 ITD mutant AML whose disease underwent SR for a brief duration without precipitating cause. We review the potential immune mechanisms underlying SR in AML and discuss the implications for novel immunotherapeutic approaches for FLT3 mutant AML. [ABSTRACT FROM AUTHOR]

Immunotherapy with immune checkpoint inhibitors has opened a new arena in cancer therapeutics. Pembrolizumab is a highly selective anti-programmed cell death protein 1 (PD-1) antibody that has shown efficacy, leading to survival benefit and durable responses, in some patients with non-small cell lung cancer (NSCLC). It has been approved by the US Food and Drug Administration for the treatment of patients with metastatic NSCLC, whose tumors express PD-1 ligand 1 (PD-L1), with disease progression on or after platinum-containing chemotherapy. Here, we briefly discuss the PD-1/PD-L1 pathway and pembrolizumab before delving into the clinical trials that have led to its just-mentioned approval in NSCLC and ongoing clinical trials. Finally, we discuss the use of biomarkers, primarily PD-L1, in the context of pembrolizumab and NSCLC. [ABSTRACT FROM AUTHOR]

Acute myeloid leukemia (AML) continues to represent an area of critical unmet need with respect to new and effective targeted therapies. The Bcl-2 family of pro- and antiapoptotic proteins stands at the crossroads of cellular survival and death, and the expression of and interactions between these proteins determine tumor cell fate. Malignant cells, which are often primed for apoptosis, are particularly vulnerable to the simultaneous disruption of cooperative survival signaling pathways. Indeed, the single agent activity of agents such as mammalian target of rapamycin (mTOR) and mitogen-activated protein kinase kinase (MEK) inhibitors in AML has been modest. Much work in recent years has focused on strategies to enhance the therapeutic potential of the bona fide BH3-mimetic, ABT-737, which inhibits B-cell lymphoma 2 (Bcl-2) and Bcl-xL. Most of these strategies target Mcl-1, an antiapoptotic protein not inhibited by ABT-737. The phosphatidylinositol-3-kinase (PI3K)/Akt/mTOR and Ras/Raf/MEK/ERK signaling pathways are central to the growth, proliferation, and survival of AML cells, and there is much interest currently in pharmacologically interrupting these pathways. Dual inhibitors of PI3K and mTOR overcome some intrinsic disadvantages of rapamycin and its derivatives, which selectively inhibit mTOR. In this review, we discuss why combining dual PI3K/mTOR blockade with inhibition of Bcl-2 and Bcl-xL, by virtue of allowing coordinate inhibition of three mutually synergistic pathways in AML cells, may be a particularly attractive therapeutic strategy in AML, the success of which may be predicted for by basal Akt activation. [ABSTRACT FROM AUTHOR]

Myeloid sarcoma represents the proliferation of myeloblasts of acute myeloid leukemia (AML) at extramedullary sites. While extramedullary involvement in AML is uncommon in itself, isolated myeloid sarcomas, that is, myeloid sarcomas without any bone marrow involvement, are extremely rare and pose a diagnostic and therapeutic challenge. Here, we present the case of a middle-aged woman with isolated myeloid sarcoma in the stomach--an organ seldom involved by this disease. Additionally, the literature on the epidemiology, diagnosis, pathology, prognosis, and therapeutic options in myeloid sarcomas has been reviewed. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to examine maternal complications that occur during the third trimester and their neonatal outcome in Arab women residing in Qatar. Design: This is a prospective hospital-based study. Setting: The survey was carried out in women's hospital. Materials and Methods: The study was based on the log book of the women's hospital, from which we recruited women in their third trimester of pregnancy between the first week of January 2010 and April 2011. Of the 1 824 Arab women who were approached to participate in the study, 1 432 (78.5%) consented. Face-to-face interviews were conducted with the pregnant women in the third trimester attending routine antenatal clinics at a women's hospital. The questionnaire covered variables related to sociodemographic factors, family history, medical history, maternal complications, and neonatal outcome. Medical records of the patients were referred to collect the clinical variables. Results: Of the pregnant women studied, 39.8% were less than 30 years of age. The risk of maternal complications was higher in housewives (60.8%) and women with a low monthly household income (38.2%). Most of the pregnant women (77.6%) had antenatal care. Normal delivery (69.7%) was more common in expatriate Arab women, whereas caesarean was more prevalent in Qatari women (22.2%). Women aged 35 years or older had a significantly higher risk of maternal complications such as gestational diabetes (20.8% vs 13.4%; P < 0.01), gestational hypertension (21.6% vs 15.2%; P = 0.003), and ante-partum hemorrhage (17.9% vs 13.7%; P = 0.042) than younger women. Gestational diabetes increased the risk of caesarean delivery (25.1%) and macrosomia (42.3%). The frequency of caesarean delivery (22.1%) was higher in women with gestational hypertension. Neonatal complications such as Apgar score (<7) 1 minute (33.1% vs 21.2%; P < 0.001), 5 minutes (13.1% vs 8.2%; P = 0.005), and congenital anomalies (2.9% vs 0.9%; P = 0.007) were significantly higher in newborns of older women. Low birth weight (11.1%) and Apgar 1st minute < 7 rate (28.2%) were higher in newborns of mothers with ante-partum hemorrhage. Conclusion: The study findings revealed that maternal complications such as gestational diabetes, gestational hypertension, ante-partum hemorrhage, and maternal anemia were significantly higher in older pregnant women. Similarly, neonatal complications were higher in the newborns of older women. Gestational hypertension was the leading maternal complication observed in Arab women. [ABSTRACT FROM AUTHOR]

The aim of this study is to determine whether excessive internet use, television viewing and the ensuing poor lifestyle habits affect low vision in school children in a rapidly developing country. This is a cross-sectional study and 3000 school students aged between six and 18 years were approached and 2467 (82.2%) students participated. Of the studied school children 12.6 percent had low vision. Most of the low vision school children were in the 6—10 years age group and came from middle income backgrounds (41.8%; p = 0.008). A large proportion of the children with low vision spent ≥ 3 hours per day on the internet (48.2%; p< 0.001) and ≥ 3 hours reclining (62.4%; p < 0.001). A significantly smaller frequency of studied children with low vision participated in each of the reviewed forms of physical activity (p < 0.001) yet a larger proportion consumed fast food (86.8%; p < 0.001). Highly significant positive correlations were found between low vision and BMI, hours spent reclining and on the internet respectively. Blurred vision was the most commonly complained of symptom among the studied children (p < 0.001). The current study suggested a strong association between spending prolonged hours on the computer or TV, fast food eating, poor lifestyle habits and low vision. [ABSTRACT FROM PUBLISHER]