title: Chronic myelocytic leukemia in pregnancy: a case report describing successful treatment using multimodal therapy.
abstract: Leukemia during pregnancy is rare, posing a complex series of questions, including appropriate therapy and maternal counseling. Management of chronic myelocytic leukemia (CML) during pregnancy is limited. Our patient presented at 30 weeks' gestation with anemia, leukocytosis, and a non-productive cough. Polymerase chain reaction performed on a peripheral blood sample confirmed presence of the breakpoint cluster region-Abl1 chromosomal translocation and the diagnosis of CML. Therapy included acute leukocytapheresis, followed by α-interferon and imatinib mesylate. The patient responded to treatment and delivered a viable female infant at term weighing 2613 g. Continued imatinib mesylate chemotherapy post-delivery resulted in complete clinical remission. Successful antepartum management of newly diagnosed CML is possible utilizing leukocytapheresis, α-interferon and, more recently, imatinib mesylate. Definitive treatment should not be delayed due to pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, University of California San Diego, San Diego, California, USA. eskander@uci.edu
authors.forename: Ramez N
authors.initials: RN
authors.lastname: Eskander
authors.forename: Maryam
authors.initials: M
authors.lastname: Tarsa
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Herbst
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Kelly
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D016898:Interferon-alpha / Q000627:therapeutic use*; D007937:Leukapheresis; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000628:therapy*; D010879:Piperazines / Q000627:therapeutic use*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy / Q000628:therapy*; D011743:Pyrimidines / Q000627:therapeutic use*; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D016898:Interferon-alpha; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate