Document Detail


How I treat acute and chronic leukemia in pregnancy.
MedLine Citation:
PMID:  18472198     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The prevalence of pregnancy associated leukemia is approximately 1 case out of 10,000 pregnancies. This rare occurrence precludes the conducting of large, prospective studies to examine diagnostic, management and outcome issues. The treatment of a pregnant woman with leukemia may be associated with severe adverse fetal outcome including death and malformations, and therefore poses a difficult challenge for both the patient and the attending physician. Chemotherapy during the 1st trimester is associated with an increased risk for congenital malformations. However, this risk diminishes as pregnancy advances. When acute leukemia is diagnosed during the 1st trimester, patients should be treated promptly similar to non-pregnant patients. However, the aggressive induction therapy should follow pregnancy termination. When the diagnosis is made later in pregnancy standard chemotherapy regimen should be considered and usually pregnancy termination is not mandatory. However, both the mother and the fetus should be under close observation and delivery should be postponed to a non-cytopenic period. Pregnancy associated chronic myelogenous leukemia (CML) can be treated with interferon throughout pregnancy with no apparent increase in adverse fetal outcome. In the very rare case of chronic lymphocytic leukemia (CLL) during pregnancy treatment can usually be delayed until after delivery.
Authors:
Tal Shapira; David Pereg; Michael Lishner
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Publication Detail:
Type:  Journal Article; Review     Date:  2008-05-09
Journal Detail:
Title:  Blood reviews     Volume:  22     ISSN:  0268-960X     ISO Abbreviation:  Blood Rev.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-04     Completed Date:  2008-12-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8708558     Medline TA:  Blood Rev     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  247-59     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine A, Meir Hospital, Sapir Medical Center, Kfar-Sava, Israel.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Induced
Adolescent
Adult
Antineoplastic Agents / adverse effects*
Child
Child, Preschool
Female
Humans
Infant
Leukemia / complications,  drug therapy*
Pregnancy
Pregnancy Complications, Neoplastic / drug therapy*
Pregnancy Trimesters
Prenatal Exposure Delayed Effects*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents

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


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