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Updated: Jun 17, 2026

Isolation of Leukocytes from the Murine Tissues at the Maternal-Fetal Interface
07:51

Isolation of Leukocytes from the Murine Tissues at the Maternal-Fetal Interface

Published on: May 21, 2015

'At the crossroads of creation and cure': leukaemia in pregnancy

Harshinee Sree Santhanam1, Suprajna Shetty2, Shraddha Shetty1

  • 1Obstetrics and Gynaecology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.

BMJ Case Reports
|June 15, 2026
PubMed

Acute leukaemia complicates 1 in 75 000 pregnancies and poses therapeutic challenges due to the teratogenic risks of chemotherapy during organogenesis. We report a case of a woman in her early 30s (adolescent/young adult (AYA) population) at 8 weeks of gestation who presented with fatigue. Peripheral blood smear suggested acute lymphoblastic leukaemia (ALL) and diagnostic tests confirmed pro B-cell type ALL. Medical termination of pregnancy was performed as per the International Federation of Gynaecology and Obstetrics guidelines due to first-trimester teratogenicity risks, followed by intrathecal methotrexate for central nervous system prophylaxis and induction as per the modified Berlin-Frankfurt-Münster regimen, a paediatric-inspired protocol selected for AYA efficacy. She achieved complete remission post-induction, with minimal residual disease <0.01% by flow cytometry and remained on maintenance therapy. This highlights the need for multidisciplinary management, psychological support for fertility and grief counselling. While first-trimester termination minimises fetal risks, continuing pregnancy with the incorporation of safer agents, such as vincristine and corticosteroids, post-organogenesis has yielded positive maternal-fetal outcomes in reported cases.

Keywords:
Antenatal DiagnosisCancer - see OncologyHaematology (incl blood transfusion)Pregnancy

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