Acute myeloid leukemia in the pregnant patient

Abstract

Although acute myeloid leukemia (AML) mostly occurs in older patients, it could be seen in women of childbearing age. It is therefore not surprising that in some patients the management of AML will be complicated by a coexistent pregnancy. However, the association of leukemia and pregnancy is uncommon. Its incidence is estimated to be 1 in 75,000 to 100,000 pregnancies. During pregnancy, most leukemias are acute: two thirds are myeloid and one third are lymphoblastic. There is no standard approach for this clinical dilemma, in part because of Accepted ArticleThis article is protected by copyright. All rights reserved.variables such as the type of AML, the seriousness of the symptoms, and the patient's personal beliefs. In many cases, the diagnostic work up has to be altered because of the pregnancy, and often available treatments have varying risks to the fetus. While chemotherapy is reported to have some risks during the first trimester, it is admitted that it can be administered safely during the second and the third trimesters.

Thrombosis in Pregnant Women with Hematological Malignancies: A Case-Based Review

“…Two-thirds of AL cases identified in pregnancy are myeloid and one-third lymphoid. 49 There is paucity of data regarding thrombosis in pregnant women with AL, which is explained by the inherent disease aggressiveness. In a single-center study, 21 women were diagnosed with AL during pregnancy: 18 had AML and 3 had ALL.…”

Successful management of acute myeloid leukaemia in a twin pregnancy – a case report

“…Chemotherapy for AML should be instigated with daunorubicin and cytarabine. Idarubicin should be avoided as it is more likely to cross the placenta (Thomas, ). All anti‐emetics have been shown to be safe in hyperemesis gravidarum but metoclopramide was avoided due to the risk of dystonic reactions (UK Tetralogy Information Service, ).…”