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CHLA ophthalmologist is improving prognosis for rare eye disease

Alan Linn Murphree, professor of ophthalmology and pediatrics in the School of Medicine, already treats almost all cases of retinoblastoma (Rb) diagnosed in Southern California – and his fame has spread across the border.

On Friday, 23-month-old Gretel Arrellanes appeared at his practice at Childrens Hospital Los Angeles (CHLA), after a 12 hour journey from the village of Caborca in Sonora, Mexico.

Gretel had already lost sight in one eye from the disease, and her oncologist in the city of Ciudad Obregon had told Gretel’s mother, Yolanda, that Murphree was the only hope of saving the other eye. Fundraising has begun, centering on the Latino community, and sparked by articles in the Los Angeles Times (June 19), La Opinion (June 21) and elsewhere, to raise money for the new regimen of chemotherapy that Murphree has developed. Contributions are already coming in.

If history repeats itself, the new therapy – which involves administration of drugs to the central circulatory system through a lock, plus intra-ocular injections – may become standard. In 1990 Murphree changed standard treatment for advanced cases of the disease – a rare condition with a strong genetic component caused by a mutation in the immature developing cells of the retina of children in their first three years.

His procedure, eliminating radiation therapy (which carries a high risk of inducing other cancers for children who carry the genetic predisposition to the disease) is widely used at the relatively small number of other centers in North America which treat Rb.

Indeed, the entire approach to the disease by the medical profession will soon have Murphree’s stamp.

The physician, who has practiced at CHLA since 1978 and taught at USC since 1991, is now engaged on a revision of the 60-year-old Reese-Ellsworth classification, producing a new system already informally known as the Murphree classification, based on new information from genetics.

Murphree also now chairs a non profit organization known as Retinoblastoma International (RBI), which has a website at www.

The site puts forward Murphree’s goals of organizing the pediatric community locally and internationally to diagnose the condition earlier to improve prognoses. (While 95 percent of treated children survive, the disease is 100 percent fatal in many underdeveloped countries).

Daytime TV star Tylo Hunter, whose child’s Rb was treated by the Murphree, has been instrumental in expanding RBI, and she and her husband sit on its board.

Meanwhile, good news for Gretel Arrellanes: an MRI scan showed no indications of spread of the disease outside the eye – and she has begin her treatment. “I can’t just send this kid back to Mexico,” Murphree said.

CHLA ophthalmologist is improving prognosis for rare eye disease

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