Successful treatment of a pregnant woman with Philadelphia chromosome-positive acute lymphoblastic leukemia

Abstract

The management of acute leukemia during pregnancy is challenging. Delays in treatment for acute leukemia can adversely affect maternal prognosis, but chemotherapy during pregnancy may induce severe adverse effects on the fetus. Here, we report a case of a pregnant woman with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph(+)ALL) who underwent remission induction therapy and successfully delivered a live infant after chemotherapy. The case is a 36-year-old woman diagnosed with Ph(+)ALL in the 27th week of pregnancy. She underwent remission induction therapy including daunorubicin, vincristine, cyclophosphamide, and prednisolone. Imatinib was not used in the induction therapy. She delivered the infant after one course of chemotherapy. The infant and the patient are both alive now, without any major complications.

Acute leukemia during pregnancy: an investigative survey of the past 11 years

“…Information on 11 pregnant women with AL was collected from four institutions, including one patient that we previously reported as a case report (patient No. 5; Table ).…”

“…Delivery is recommended at least 2 or 3 weeks after the last chemotherapy to allow maternal/fetal bone marrow recovery and fetal drug excretion via the placenta []. In our survey, elective cesarean section was planned after bone marrow recovery for the two patients who received chemotherapy during pregnancy.…”

Treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia in pregnancy

“…Two women were treated with chemotherapy and delivered healthy babies, then initiated IM or dasatinib after delivery. 25,26 Our patient was treated with hyperCVAD and IM beginning week 24 of pregnancy and delivered a healthy baby at 30 weeks, but unfortunately later died of chemotherapy complications.…”

A Case of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia in a 26-Year-Old Pregnant Woman

“…Tyrosine kinase inhibitors (TKIs), such as imatinib, emerged as a fundamental component of initial therapy for Ph+ ALL, achieving remission rates of over 90% regardless of whether imatinib is administered as monotherapy or in conjunction with chemotherapy [ 3 ]. Delays in managing acute leukemia can negatively impact the mother’s prognosis, yet administering chemotherapy during pregnancy can lead to severe adverse effects on the fetus [ 4 ]. Herein is a case report of a young pregnant patient diagnosed with ALL outlining the complexities of treatment.…”