[Treatment for acute promyelocytic leukemia during pregnancy].
OBJECTIVE
To study the experience in managing patients with acute promyelocytic leukemia (APL) diagnosed in different periods of pregnancy.


METHODS
Nine women with APL were treated in 1998-2013. When APL was diagnosed in the first trimester of pregnancy, the latter was terminated (n = 1); when its diagnosis was made in the second trimester, chemotherapy (CT) followed by delivery (D) was performed (n = 3); when it was done in the third trimester, D followed by CT was done in relation to gestational age (n = 2) or these were performed at a later gestational age (n = 1). APL was treated in 5 and 1 patients according to the AIDA protocol and the 7+3 plus ATRA one, respectively.


RESULTS
All the patients with APL achieved remission after the first cycle of induction CT; 5 of the 6 patients did at the moment of delivery; one patient underwent emergency delivery during cytopenia after the cycle. The gestational age at delivery after CT was 34 (34-40) weeks. Spontaneous term labor occurred in 2 patients at an obstetric hospital. Cesarean section was made in 4 of the 6 patients. All babies were born alive, healthy, and without developmental abnormalities. Their age at the time of analyzing the results was 2.5 months to 15 years. Four of the 9 patients are presently alive. Late recurrences occurred in 3 (33%) patients. The median overall survival is 26 (0.25-128) months; the median relapse-free survival is 17.5 (0-127) months.


CONCLUSIONS
APL treatment in pregnant women, which is aimed at saving two lives, is effective and reasonable.
V V
VV
Troitskaia
E N
EN
Parovichnikova
A N
AN
Sokolov
A V
AV
Kokhno
S A
SA
Makhinia
G M
GM
Galstian
T S
TS
Konstantinova
L A
LA
Mazurok
I G
IG
Goriachok
A V
AV
Korobkin
M A
MA
Liubshenko
O A
OA
Latyshkevich
A V
AV
Zvereva
M A
MA
Kurtser
V G
VG
Savchenko
D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005971:Glutamates / Q000627:therapeutic use*; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011355:Prodrugs; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D014212:Tretinoin / Q000627:therapeutic use*; D055815:Young Adult
D005971:Glutamates; D011355:Prodrugs; C546472:retinoyl glutamate; D014212:Tretinoin