Acute promyelocytic leukemia during pregnancy: report of 3 cases.
Acute promyelocytic leukemia (APL) is characterized by onset at a young age and a life-threatening hemorrhagic diathesis, which is attributed to a disseminated intravascular coagulation (DIC)-like coagulopathy. The discovery of all-trans-retinoic acid has changed the course of APL treatment by reducing the onset of DIC and inducing a complete and durable remission in more than 90% of patients. The occurrence of APL during pregnancy is not a frequent event, but the management of these patients raises many therapeutic and ethical dilemmas and requires a careful clinical case evaluation of fetal and maternal risk, coagulation status, the parents' wishes, and therapeutic options. Here we describe 3 patients with APL diagnosed during pregnancy. Clinical data and the therapeutic approaches are presented. In the discussion, we analyze clinical decisions and therapeutic options and compare our cases with those found in the literature.
Chair and Division of Haematology with Bone Marrow Transplantation Unit, University of Catania, Catania, Italy. ugo.consoli@tin.it
Ugo
U
Consoli
Amalia
A
Figuera
Giuseppe
G
Milone
Carmela Rita
CR
Meli
Giulia
G
Guido
Francesco
F
Indelicato
Gaetano
G
Moschetti
Salvatore
S
Leotta
Antonella
A
Tornello
Massimo
M
Poidomani
Pamela
P
Murgano
Valeria
V
Pinto
Rosario
R
Giustolisi
D000014:Abnormalities, Drug-Induced / Q000517:prevention & control; D000032:Abortion, Therapeutic; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019090:Case Management; D002585:Cesarean Section; D017809:Fatal Outcome; D005260:Female; D005865:Gestational Age; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D007231:Infant, Newborn; D015473:Leukemia, Promyelocytic, Acute / Q000175:diagnosis / Q000628:therapy; D008297:Male; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000628:therapy; D012074:Remission Induction; D012306:Risk; D012449:Safety; D014212:Tretinoin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
D000970:Antineoplastic Agents; D014212:Tretinoin; D015255:Idarubicin