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Chemotherapy for acute leukemia during pregnancy. Five case reports
Nouvelle Revue Francaise D'Hematologie
|January 1, 1984
Summary
Chemotherapy for acute myeloid leukemia (AML) and acute lymphoid leukemia (ALL) during pregnancy can lead to remission and live births. This approach may reduce maternal mortality and improve fetal outcomes.
Area of Science:
- Oncology
- Maternal-Fetal Medicine
Background:
- Pregnancy with acute leukemia presents unique challenges for maternal and fetal health.
- Limited data exists on the safety and efficacy of chemotherapy during pregnancy for these conditions.
Observation:
- Four women with acute myeloid leukemia (AML) and one with acute lymphoid leukemia (ALL) were treated during pregnancy.
- Chemotherapy regimens included doxorubicin, vincristine, cytosine arabinoside, prednisone, and vindesine.
- Successful remission was achieved in all patients, with 3 AML and 1 ALL case achieving complete remission.
Findings:
- Four live births occurred, with three spontaneous deliveries and one Cesarean section, all resulting in healthy male infants.
- One patient with AML underwent elective abortion in early pregnancy while in remission.
- Maternal survival rates were improved post-partum, with all mothers alive at follow-up periods ranging from 15 to 42 months.
Implications:
- Current chemotherapy protocols show promise in improving maternal survival and achieving live births in pregnant patients with acute leukemia.
- Treatment during pregnancy may offer a viable option with acceptable risks to both mother and fetus, even in early gestation.
- Further research is warranted to optimize chemotherapy regimens for pregnant women with acute leukemia to further reduce maternal mortality.