Outcome of pregnancy in women treated with all-<i>trans</i> retinoic acid; A case report and review of literature

Valappil, Saudabi; Kurkar, Micheal; Howell, Rosemary

doi:10.1080/10245330701448594

Cited by 38 publications

(25 citation statements)

References 4 publications

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“…ATRA decreases the risk of DIC and increases the cure rate to more than 70%. Use of ATRA in pregnancy was first published in 1994 and since then there have been 29 case reports of ATRA use in pregnancy [136][137][138][139]. ATRA given in the first trimester carries an 85% risk of teratogenicity, including severe neurological and cardiovascular complications, and together with chemotherapy is associated with an increased rate of miscarriage [10].…”

Section: Acute Leukemiasmentioning

confidence: 99%

Management of hematological malignancies during pregnancy

et al. 2009

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The management of hematological malignancies during pregnancy is a challenging endeavor, which not only requires technical skills and knowledge by the clinicians but also requires sound clinical judgment and compassion, keeping in mind the patient and family preferences and, ultimately, the wellbeing of the neonate. The incidence of hematological malignancies during pregnancy is rare, ranging from 1 in 1,000 to 1 in 10,000 deliveries, impeding the design and execution of large prospective studies. The purpose of this review is to evaluate the limited existing data and make useful suggestions in the management of acute and chronic leukemias, Hodgkin and non‐Hodgkin lymphomas, plasma cell myeloma, and other hematological malignancies, such as myelodysplastic syndromes and hairy cell leukemia, during pregnancy. Am. J. Hematol. 2009. © 2009 Wiley‐Liss, Inc.

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Section: Acute Leukemiasmentioning

confidence: 99%

Management of hematological malignancies during pregnancy

et al. 2009

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“…A normal outcome was also reported for 6-mercaptopurine administration in the second trimester. 29 All of the patients who received purine analogs in these cases achieved complete remission. 7, 11, 13-15, 19-23, 29…”

Section: Pyrimidine Analogsmentioning

confidence: 96%

“…There were five reported cases of prematurity, six cases of low birth weight (adjusted for gestational age), and two cases of arrhythmia. 16,17,21,22,25,28,29,[35][36][37]71 Of note, both cases of cardiac arrhythmia occurred with single-agent ATRA. 16,35 In contrast, most pregnancies associated with ATRA and other chemotherapy agents in the first trimester ended in either spontaneous or elective abortion.…”

Section: Treatment Strategiesmentioning

confidence: 99%

“…Idarubicin 12 mg/m 2 /day on days 2, 4, 6, and 8, and Cesarean ATRA 45 mg/m 2 /day; consolidation with idarubicin 5 mg/m 2 /day and cytarabine 1000 mg/m 2 /day on days 1, 2, 3, and 4 and ATRA 45 mg/m 2 /day x 15 days 16 26 25 28 Idarubicin, ATRA Cesarean 37 27 26 NA Daunorubicin 45 mg/m 2 /day, cytarabine 100 mg/m 2 /day Spontaneous abortion 27 3 28 NR ATRA Vaginal 35 28 25 NR Cytarabine, daunorubicin, and ATRA NR 23 29 Complete remission normal growth and development at 12 mo of follow-up 1634-g (low-birth-weight) infant required intubation for respiratory Complete remission distress syndrome; patent ductus arteriosus; ATRA detected in plasma; normal growth and development at 36 mo of follow-up cardiovascular abnormalities has been described with the administration of 13-cis-retinoic acid in the first trimester of pregnancy. 17 It was not until 1994 that the use of ATRA for the treatment of APL in the second and third trimesters was first described in the literature.…”

Section: All-trans-retinoic Acidmentioning

confidence: 99%

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Treatment of Acute Promyelocytic Leukemia During Pregnancy

Yang

Hladnik

2009

Pharmacotherapy

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Management of the pregnant patient with acute promyelocytic leukemia (APL) is a challenge. Immediate treatment of APL is critical, as it is an oncologic emergency, with a high risk of morbidity and mortality associated with disseminated intravascular coagulation. However, administration of chemotherapy and differentiating agents in pregnancy is controversial because of potential teratogenic effects. In addition, complications associated with APL, including retinoic acid syndrome, add to the complexity of management. To better understand how to manage this complex patient care situation, we searched the PubMed database (January 1972-May 2008) for English-language articles about maternal and fetal outcomes resulting from APL treatment during pregnancy. A total of 42 cases from 35 articles were identified: 12 first-trimester, 21 second-trimester, and 9 third-trimester cases. The most commonly administered agents were all-trans-retinoic acid (ATRA), anthracyclines, and antimetabolites. Complete remission was reported in 35 (83%) of 42 patients. Administration of ATRA or chemotherapy in the first trimester was associated with an increased risk of fetal malformations and spontaneous abortion, whereas administration in the second and third trimesters was associated with relatively favorable fetal outcomes. The overall treatment of the pregnant patient with APL should include a discussion about pregnancy termination, especially if APL is diagnosed in the first trimester. If the pregnancy is to continue, then the appropriate chemotherapy regimen needs to be determined. Frequent fetal monitoring, along with aggressive management of potential APL-related complications, is necessary to allow for optimal maternal and fetal outcomes.

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“…Historically, retinoic acid, also known as a potent inducer of the collagen biosynthesis, has been used as a key cosmetic material commercially (9). Unfortunately, overdoses of retinoic acids, a family of lipid-soluble vitamins, are known to have negative side effects in pregnant women and children (10).…”

Section: Introductionmentioning

confidence: 99%

A novel L-ascorbic acid and peptide conjugate with increased stability and collagen biosynthesis

Choi¹,

Park²,

Kim³

et al. 2009

BMB Reports

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L-ascorbic acid (Vitamin C) and peptide are both useful compounds for collagen biosynthesis in cosmeceuticals (cosmetic and pharmaceutical fields). The instability of these compounds, however, limit their application in these industries. In this report, we describe the development of a novel compound, Stabilized Ascorbyl Pentapeptide (SAP), which physically is much more stable than L-ascorbic acid in water. The inhibitory effects of this SAP compound on tyrosinase and melanin synthesis is comparable to that of L-ascorbic acid. Importantly, the SAP compound displays no cytotoxicity at a high concentration (5 mM). The ability of SAP to promote collagen biosynthesis is greater than that of L-ascorbic acid or the KTTKS peptide alone. Considering the in vitro stability and functional effects, our data strongly suggest that the SAP compound is a good candidate not only as a cosmetic ingredient, but also as a wound healing agent. [BMB reports 2009; 42(11): 743-746]

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Outcome of pregnancy in women treated with all-trans retinoic acid; A case report and review of literature

Cited by 38 publications

References 4 publications

Management of hematological malignancies during pregnancy

Management of hematological malignancies during pregnancy

Treatment of Acute Promyelocytic Leukemia During Pregnancy

A novel L-ascorbic acid and peptide conjugate with increased stability and collagen biosynthesis

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