Reversible foetal cerebral ventriculomegaly and cardiomyopathy under chemotherapy for maternal AML.
BACKGROUND
Leukaemia in pregnancy is a rare complication demanding a multidisciplinary approach and careful management to handle potential complications and cope with ethical dilemmas.


METHODS
We report on a patient with acute myeloid leukaemia (AML) relapse in 22 weeks of gestation who received chemotherapy with cytarabine and mitoxantrone, as well as fludarabine, cytarabine, idarubicin, and gemtuzumabozogamicin. We describe findings on regular ultrasound examinations and successful management of complications.


RESULTS
The foetus developed signs of anthracycline-induced cardiomyopathy, transient cerebral ventriculomegaly, anaemia, and intrauterine growth restriction. The child was delivered by Caesarean section at 33 + 1 weeks of gestation. The newborn showed no congenital malformations.


CONCLUSIONS
This case report confirms that chemotherapy for treatment of AML can be applied in the second trimester of pregnancy under close and careful maternal and foetal monitoring.
Baumgärtner
Anne K
AK
Abteilung Perinatalmedizin, Frauenklinik rechts der Isar der Technischen Universitat München, Ismaninger Strasse 22, Munich, Germany. annebaumgaertner@web.de
Oberhoffer
R
R
Jacobs
Volker R
VR
Ostermayer
E
E
Menzel
H
H
Voigt
M
M
Schneider
K T M
KT
Pildner von Steinburg
S
S
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects*; D009202:Cardiomyopathies / Q000139:chemically induced* / Q000196:embryology; D002552:Cerebral Ventricles / Q000002:abnormalities* / Q000187:drug effects; D005260:Female; D005315:Fetal Diseases / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy* / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult