Successful pregnancy in the context of previously undiagnosed chronic lymphocytic leukaemia: A case report and literature review

Introduction: Chronic Lymphocytic Leukemia (CLL) is a rare hematologic malignancy to occur in pregnancy, with an estimated incidence of 1 in 75,000 pregnancies. Objective: This review aimed to summarize the current evidence regarding the diagnosis, prognosis, and treatment of CLL in pregnant cases. Methods: A comprehensive search strategy was employed across multiple databases, yielding 14 case reports for inclusion. The cases were divided based on CLL diagnosis onset, either before or during pregnancy. Results: Patients diagnosed during pregnancy (n=5) were mostly asymptomatic at diagnosis, with management ranging from supportive care to leukapheresis and transfusions. Postpartum treatment varied, with some patients requiring no additional therapy and others receiving chemotherapy. Pregnancy outcomes were generally favorable, with most neonates born healthy at term. However, one case of Richter transformation resulted in maternal death despite treatment. Among patients with pre-existing CLL (n=9), the majority experienced an indolent course during pregnancy, with only supportive care required. A few cases necessitated treatment due to progressive disease or complications, including chemotherapy, leukapheresis, and splenectomy. Conclusion: Overall, this review highlights the heterogeneous nature of CLL in pregnancy and the importance of individualized management based on disease severity, gestational age, and maternal-fetal risks. Close monitoring, supportive care, and a multidisciplinary approach are essential for optimizing outcomes in this rare and complex clinical scenario.

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Chronic lymphocytic leukemia diagnosed during pregnancy - case report and review of literature

Marisavljević

Kraguljac-Kurtovic²,

Stanisavljević

2022

Srp Arh Celok Lek

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Introduction. B-cell chronic lymphocytic leukemia (CLL) can be easily overlooked in pregnancy, particularly in cases with inadequate antenatal care. We report a case of pregnant woman diagnosed with CLL and evaluate this patient to cases in the literature. Case report. An asymptomatic 35-year-old woman presented with slightly elevated absolute lymphocyte count at antenatal monitoring in her second pregnancy. Further hematological investigations disclosed CLL with monoallelic deletion of chromosome 13q14. She was monitored during throughout the pregnancy, being asymptomatic and without treatment, and delivered a healthy child at term with no complications. After almost four years of follow up patient is without any signs of disease progression and her absolute lymphocyte counts remained on predelivery levels. This is the first published case of CLL diagnosed during pregnancy in Serbia. Rare similar cases published so far have been discussed, especially in terms of disease course, long-term prognosis and available therapeutic modalities. Conclusion. Due to the fact that nowadays many women are delaying childbearing in middle age it can be expected that cancer diagnose could be more often found in pregnant women in the future. In a view of the complex nature of such condition, a multidisciplinary approach for diagnosing and treating of pregnant women is highly recommended.

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Successful pregnancy in the context of previously undiagnosed chronic lymphocytic leukaemia: A case report and literature review

Cited by 3 publications

References 21 publications

Clinical Perspectives for Leukemia Treatment During Pregnancy

Clinical Perspectives for Leukemia Treatment During Pregnancy

Chronic Lymphocytic Leukemia in Pregnancy: A Review of the Available Literature and the Pharmacological Challenges in Management

Chronic lymphocytic leukemia diagnosed during pregnancy - case report and review of literature

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