Maternal and Fetal Outcomes in Pregnant Women with Acute Leukemia

Acute leukemia (AL) during pregnancy is a rare condition with limited evidence-based information available on the management. The study aims to analyze the pregnancy and fetal outcomes of pregnant women with acute leukemia diagnosed during pregnancy.

In this retrospective study, 18 pregnant women who were diagnosed with AL during pregnancy from January 2013 to January 2024 were reviewed.

Of these patients, 6 delivered before chemotherapy while 12 received chemotherapy after induced abortion. Six fetus were born through spontaneous delivery or cesarean section, and one died 3 days after birth. Fourteen patients (77.8%) were found to have decreased platelets by full blood count test. The delivery group had a longer gestational age, longer time from pregnancy termination to chemotherapy compared to the abortion group. The median age of the rest 5 newborns was 32 months. Five newborns were healthy without any deformities or developmental issues. With a median follow-up of 3 years, the overall survival (OS) rates for 18 patients with acute leukemia were estimated at 88.2%. Patients in the delivery group had a significantly lower OS rate compared to those in abortion group. Overall, starting chemotherapy as soon as possible can improve OS rates for pregnant women with AL.

Collectively, we suggest that for pregnant patients diagnosed in early or late stages of pregnancy (after 30 weeks), opting for termination of pregnancy before starting chemotherapy could lead to better outcomes for the mothers.