Document Detail

Pregnancy during therapy for childhood acute lymphoblastic leukemia: two case reports and a review of the literature.
MedLine Citation:
PMID:  9544169     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The incidence and consequences of pregnancy during therapy for childhood acute lymphoblastic leukemia (ALL) are largely unknown. To explore the issues involved in this complication of ALL treatment, two recent cases are presented.
PATIENTS: Two 15-year-old girls with "high risk" ALL became pregnant while receiving maintenance therapy.
RESULTS: In one case, the patient experienced a spontaneous abortion at approximately 5 to 6 weeks gestation. The patient completed maintenance therapy and is in remission 8 months after the end of treatment. The second patient, known to be non-compliant during therapy, was found to be 5 months pregnant at the end of maintenance therapy. She developed HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count), was induced at approximately 34 weeks, and delivered an apparently normal baby girl. Both the patient and her baby continue to do well 10 months after delivery.
CONCLUSIONS: A variety of factors may influence the incidence of pregnancy during ALL therapy. Gonadal function, which is likely to return to normal during maintenance therapy, may also be affected by alterations in the dose intensity of treatment. Social factors may also alter the incidence of pregnancy. Adverse effects on the fetus are more likely to occur in the first trimester, depending on the drug or drugs used. Although all chemotherapies may have mutagenic and teratogenic effects, they do not invariably cause abnormalities. Survival of adolescents who become pregnant during treatment does not appear to be adversely affected when therapy is not modified or discontinued.
S K Bergstrom; A J Altman
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Journal of pediatric hematology/oncology     Volume:  20     ISSN:  1077-4114     ISO Abbreviation:  J. Pediatr. Hematol. Oncol.     Publication Date:    1998 Mar-Apr
Date Detail:
Created Date:  1998-04-29     Completed Date:  1998-04-29     Revised Date:  2011-10-06    
Medline Journal Info:
Nlm Unique ID:  9505928     Medline TA:  J Pediatr Hematol Oncol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  154-9     Citation Subset:  IM    
Connecticut Children's Medical Center, University of Connecticut School of Medicine, Department of Pediatrics 06106, USA.
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MeSH Terms
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
Pregnancy Complications, Neoplastic*

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