[Two cases of acute promyelocytic leukemia in pregnancy and the effect of anthracyclines on fetal development].
Two patients with acute promyelocytic leukemia (APL) in 2nd and 3rd trimester of pregnancy are reported on. Case 1: 38-year-old female consulted our hospital because of bleeding tendency and pancytopenia in April, 1988. She was diagnosed as having APL with disseminated intravascular coagulopathy (DIC) and was found to be in the 14th week of gestation. Combined chemotherapy (BHAC-DMP) including the total dose (440 mg) of daunorubicin (DNR) resulted in intrauterine fetal death at 19 weeks of gestation. The fetus was severely anemic and the bone marrow was hypoplastic. Case 2: A 27-year-old female was diagnosed as having APL with DIC at 29 weeks of gestation. BHAC-DMP including 440 mg DNR achieved complete remission. At 35 weeks of gestation, she delivered a normal infant by Caesarean section. The child had normal hematological findings and showed normal growth. Both cases developed APL accompanied by DIC during pregnancy and were treated with a similar regimen including high dose of anthracyclines. Case 2 treated in the late period of gestation delivered a normal infant, while fetal death resulted in case 1, treated in the early period of gestation. We reviewed the literature regarding chemotherapy using anthracyclines during pregnancy.
Takatsuki
H
H
Third Department of Internal Medicine, Faculty of Medicine, Kyushu University.
Abe
Y
Y
Goto
T
T
Sadamura
S
S
Taguchi
F
F
Muta
K
K
Miyoshi
T
T
Katsuno
M
M
Umemura
T
T
Nishimura
J
J
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage / Q000031:analogs & derivatives; D003630:Daunorubicin / Q000008:administration & dosage / Q000009:adverse effects*; D005314:Embryonic and Fetal Development / Q000187:drug effects*; D005260:Female; D005313:Fetal Death / Q000139:chemically induced; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D015122:Mercaptopurine / Q000008:administration & dosage; D011239:Prednisolone / Q000008:administration & dosage; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy*
D003561:Cytarabine; D011239:Prednisolone; D015122:Mercaptopurine; D003630:Daunorubicin