Document Detail


Successful treatment of acute promyelocytic leukaemia during pregnancy.
MedLine Citation:
PMID:  12358893     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A case is reported of a pregnant 16-year-old-woman diagnosed with Acute promyelocytic leukaemia (APL) at 25 weeks gestation and treated with all-trans retinoic acid (ATRA) (45 mg/m2) for 25 days in combination with chemotherapy. She achieved a complete cytogenetic and molecular remission. Clinical course was complicated, with an intracerebral bleed, respiratory failure requiring ventilation and prolonged pancytopenia following initial chemotherapy. A live female infant was born at 28 weeks gestation who survived to discharge with significant pulmonary complications. She remains oxygen dependent at 6 months of age. ATRA has been used from the 3rd week of gestation, but fetal malformations are common during the first trimester. In contrast it seems to be safe in the second and third trimesters with regard to teratogenesis but can cause other side-effects. Most successful outcomes in treatment of APL during pregnancy are seen after treatment with ATRA and delivery of the baby at as late a stage as possible. Pregnancies terminated before remission has been obtained or those treated in the first trimester have a poor maternal outcome.
Authors:
D Carradice; N Austin; K Bayston; P S Ganly
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical and laboratory haematology     Volume:  24     ISSN:  0141-9854     ISO Abbreviation:  Clin Lab Haematol     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-10-02     Completed Date:  2003-03-17     Revised Date:  2006-04-24    
Medline Journal Info:
Nlm Unique ID:  7907061     Medline TA:  Clin Lab Haematol     Country:  England    
Other Details:
Languages:  eng     Pagination:  307-11     Citation Subset:  IM    
Affiliation:
Department of Haematology, Christchurch Hospital, New Zealand. duncancarradice@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anticonvulsants / therapeutic use
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Cerebral Hemorrhage / drug therapy,  etiology
Cesarean Section
Dexamethasone / therapeutic use
Diuretics / therapeutic use
Epilepsy, Tonic-Clonic / drug therapy,  etiology
Female
Fetal Growth Retardation / etiology
Humans
Idarubicin / administration & dosage
Infant, Newborn
Leukemia, Promyelocytic, Acute / complications,  drug therapy*
Lung / abnormalities
Neutropenia / chemically induced
Nutrition Disorders / etiology,  therapy
Oxygen / therapeutic use
Parenteral Nutrition, Total
Pregnancy
Pregnancy Complications / etiology,  therapy
Pregnancy Complications, Neoplastic / drug therapy*
Remission Induction
Respiration Disorders / congenital,  etiology
Tranexamic Acid / therapeutic use
Tretinoin / administration & dosage
Chemical
Reg. No./Substance:
0/Anticonvulsants; 0/Diuretics; 1197-18-8/Tranexamic Acid; 302-79-4/Tretinoin; 50-02-2/Dexamethasone; 58957-92-9/Idarubicin; 7782-44-7/Oxygen

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


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