Document Detail


Pregnancy and leukemia.
MedLine Citation:
PMID:  2678488     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
As increasing numbers of children and adults with leukemia have become long-term survivors, the impact of an existing pregnancy on leukemia treatment, as well as the significance of prior leukemia therapy on future pregnancies, have become sources of concern. The information presently available, derived from small, retrospective series or case reports, indicates that leukemia may develop throughout pregnancy, that a leukemia woman who is pregnant need not undergo an abortion if she does not desire, and that standard antileukemic chemotherapy can be administered safely during the second and third trimesters. The antifolates (eg, methotrexate), being particularly teratogenic, should be avoided during the first trimester. Cytarabine and anthracycline treatment, the fundamental components of management for patients with AML, has not been associated with birth defects. The risk for placental injury, sepsis, and spontaneous abortion or premature birth is undoubtedly increased in women who experience the periodic episodes of myelosuppression that accompany leukemia treatment. Once remission has been achieved, decisions regarding adjustments of the intensity of therapy must be made with each individual patient; such dose alterations may diminish the mother's potential for long-term leukemia control, while possibly securing the viability of the fetus. Similarly, issues such as elective delivery prior to term and vaginal delivery v caesarean section should be resolved on a patient-by-patient basis. The offspring of leukemic mothers appear to mature normally.
Authors:
M A Caligiuri; R J Mayer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Seminars in oncology     Volume:  16     ISSN:  0093-7754     ISO Abbreviation:  Semin. Oncol.     Publication Date:  1989 Oct 
Date Detail:
Created Date:  1989-11-17     Completed Date:  1989-11-17     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0420432     Medline TA:  Semin Oncol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  388-96     Citation Subset:  IM    
Affiliation:
Dana-Farber Cancer Institute, Harvard Medical School, Boston 02115.
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Drug-Induced / etiology
Antineoplastic Agents / adverse effects,  therapeutic use*
Female
Humans
Infant, Newborn
Leukemia / drug therapy*
Pregnancy
Pregnancy Complications, Neoplastic / drug therapy*
Prognosis
Grant Support
ID/Acronym/Agency:
5P01CA34183-06/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Antineoplastic Agents

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


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