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Acute leukemia and pregnancy. Case report

D Veneri1, G Todeschini, G Pizzolo

  • 1Department of Hematology, University of Verona, Italy.

Clinical and Experimental Obstetrics & Gynecology
|January 1, 1996
PubMed
Summary

This case report details a successful pregnancy with acute myeloid leukemia (AML) managed with chemotherapy and autologous bone marrow transplant (ABMT). Despite a relapse, the child remains healthy, highlighting the feasibility of treating pregnant women with AML.

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Area of Science:

  • Hematology
  • Oncology
  • Obstetrics

Background:

  • Acute myeloid leukemia (AML) during pregnancy is rare and poses significant management challenges.
  • Treatment decisions involve balancing maternal anti-leukemic therapy with fetal well-being.
  • This case explores the management of AML in a pregnant patient without therapeutic abortion.

Observation:

  • A 27-year-old female diagnosed with AML (FAB M4) at 20 weeks gestation opted for treatment.
  • She received standard chemotherapy (doxorubicin, cytarabine, 6-thioguanine) followed by autologous bone marrow transplant (ABMT).
  • Fetal development was monitored, and an urgent cesarean section was performed at 29 weeks due to fetal distress.

Findings:

  • Complete remission of AML was achieved with chemotherapy.

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  • No fetal malformations were observed.
  • The patient relapsed 14 months after diagnosis, succumbing to AML 7 months post-ABMT.

    • Implications:

    • Managing acute myeloid leukemia in pregnancy is feasible with a multidisciplinary approach.
    • Tertiary care institutions are best equipped for such complex cases.
    • The case demonstrates a positive outcome for the child despite maternal relapse.