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Acute leukemia during pregnancy
Author(s) -
Chelghoum Youcef,
Vey Norbert,
Raffoux Emmanuel,
Huguet Françoise,
Pigneux Arnaud,
Witz Brigitte,
Pautas Cécile,
de Botton Stéphane,
Guyotat Denis,
Lioure Bruno,
Fegueux Nathalie,
Garban Frédéric,
Saad Hussam,
Thomas Xavier
Publication year - 2005
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21137
Subject(s) - medicine , pregnancy , abortion , therapeutic abortion , myeloid leukemia , leukemia , acute leukemia , chemotherapy , gestation , disease , obstetrics , pediatrics , surgery , genetics , biology
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. Cancer 2005. © 2005 American Cancer Society.