title: Refusal of treatment for acute leukemia in pregnancy: a case report.
abstract: BACKGROUND
  Acute leukemia is rare in pregnancy. The importance of promptly diagnosing and treating this disease in pregnancy stems from its life-threatening potential, both to the mother and fetus.
  
  
  METHODS
  We report a case of relapse of acute myeloid leukemia at 23 weeks of pregnancy in a 24-year-old Albanian woman. Our patient categorically refused chemotherapy treatment, and in her 35th week of gestation, severe hemorrhagic diathesis rapidly developed. The manifestation and course of this life-threatening complication posed therapeutic challenges for the attending medical team.
  
  
  CONCLUSIONS
  Based both on our experience and the results of other gynecological studies, there exists a strong indication that the earlier a patient's chemotherapy treatment begins, the better the maternal outcome. We support chemotherapy for patients who are pregnant presenting with such illness. The present case report testifies that refusal of chemotherapy by such patients is a high-risk decision.
authors.affiliation: Obstetrics and Gynecology Clinic, University Clinical Center of Kosova, Prishtina, 10000, Kosova. drsyheda@yahoo.com.
authors.forename: Syheda Latifi
authors.initials: SL
authors.lastname: Hoxha
authors.forename: Vlora Ademi
authors.initials: VA
authors.lastname: Ibishi
authors.forename: Ahmet
authors.initials: A
authors.lastname: Brovina
authors.forename: Mynevere
authors.initials: M
authors.lastname: Hoxha
authors.forename: Shefqet
authors.initials: S
authors.lastname: Lulaj