Document Detail


Acute leukemia during pregnancy: a report on 37 patients and a review of the literature.
MedLine Citation:
PMID:  15912518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Acute leukemia (AL) requiring cytotoxic treatment occurring during pregnancy poses a very difficult therapeutic dilemma. METHODS: By means of a mail questionnaire, information on a series of 37 patients with a diagnosis of AL during pregnancy was collected from 13 French centers between December, 1988 and November, 2003. RESULTS: Thirty-one patients had acute myeloid leukemia (AML), and 6 patients had acute lymphoblastic leukemia (ALL). Nine patients were diagnosed during the first trimester, 10 patients were diagnosed during the second trimester, and 18 patients were diagnosed during the third trimester. Fifteen pregnancies ended with therapeutic or spontaneous abortion. There were 13 normal deliveries, including 1 gemellary pregnancy, and 9 Cesarean sections. Twenty-three healthy babies survived from the 37 pregnancies, of whom 15 babies had been exposed to chemotherapeutic agents. A complete remission was achieved in 34 patients. Eleven women had severe extrahematologic complications during the induction remission course. The median disease-free survival (DFS) was not reached, with a 5-year DFS of 54%. Ten patients developed recurrent disease. Overall, 12 of 37 pregnant women died from leukemia. CONCLUSIONS: Pregnancy does not affect the course of AL. In the first trimester, termination of pregnancy should be discussed because of the potential fetal consequences of chemotherapy. Chemotherapy treatment during the second or third trimester may not require termination of pregnancy, because as remission of AL and delivery of a normal infant are likely to be obtained.
Authors:
Youcef Chelghoum; Norbert Vey; Emmanuel Raffoux; Françoise Huguet; Arnaud Pigneux; Brigitte Witz; Cécile Pautas; Stéphane de Botton; Denis Guyotat; Bruno Lioure; Nathalie Fegueux; Frédéric Garban; Hussam Saad; Xavier Thomas
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Cancer     Volume:  104     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-06-27     Completed Date:  2005-08-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  110-7     Citation Subset:  AIM; IM    
Affiliation:
Service d'Hématologie Clinique, Hôpital Edouard Herriot, Lyon, France.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Antineoplastic Combined Chemotherapy Protocols / adverse effects,  therapeutic use
Female
Humans
Leukemia / drug therapy*
Leukemia, Myeloid / drug therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
Pregnancy
Pregnancy Complications, Neoplastic*
Pregnancy Outcome
Pregnancy Trimesters
Remission Induction

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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