Acute leukemia developing in the second trimester of pregnancy

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  • HORIGOME Yuichi
    Department of Hematology, Kitasato University School of Medicine
  • TADERA Noriyuki
    Department of Hematology, Kitasato University School of Medicine
  • MICHISHITA Yusuke
    Department of Hematology, Kitasato University School of Medicine
  • MOTOHASHI Tomomi
    Department of Hematology, Kitasato University School of Medicine
  • ISHIDA Takashi
    Department of Hematology, Kitasato University School of Medicine Department of Transfusion and Cell Transplantation, Kitasato University School of Medicine
  • OKINA Sosei
    Department of Hematology, Kitasato University School of Medicine
  • KAMATA Hirotoshi
    Department of Hematology, Kitasato University School of Medicine
  • MIYAZAKI Koji
    Department of Transfusion and Cell Transplantation, Kitasato University School of Medicine
  • SUZUKI Takahiro
    Department of Hematology, Kitasato University School of Medicine

Bibliographic Information

Other Title
  • 妊娠第2期に発症した急性白血病
  • 症例報告 妊娠第2期に発症した急性白血病
  • ショウレイ ホウコク ニンシン ダイ2キ ニ ハッショウ シタ キュウセイ ハッケツビョウ

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Abstract

<p>Acute leukemia (AL) during pregnancy poses a substantial risk to both mothers and fetuses. Treatment for leukemia should be initiated promptly; however, the management of AL in pregnant women and fetuses is usually challenging, especially during the second trimester. Here, we report two cases of AL that developed during the second trimester of pregnancy. In one case, chemotherapy was initiated while continuing the pregnancy; in the second case, a cesarean section was performed prior to chemotherapy initiation. As per current medical records, both infants are thriving without any medical problems. The optimal strategy for the treatment of AL during pregnancy typically includes chemotherapy after delivery. However, if fetal development is not sufficient for ex utero survival, the only alternatives available are the initiation of treatment while continuing the pregnancy or treatment after therapeutic abortion (if it is legally allowed). According to previous studies and as per the results from our first case, the initiation of chemotherapy while sustaining the pregnancy may be an acceptable option if it is conducted with appropriate informed consent. The treatment of AL in the second trimester of pregnancy should be carefully decided, while taking into account the medical, legal, and social aspects, such as gestational weeks, maternal and fetal status, and wishes of the patients and their families.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 61 (8), 865-869, 2020

    The Japanese Society of Hematology

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