title: Chronic lymphocytic leukaemia, monoclonal B-lymphocytosis and pregnancy: five cases, a literature review and discussion of management.
abstract: Chronic lymphocytic leukaemia (CLL) occurs rarely with pregnancy and monoclonal B-Lymphocytosis (MBL) has not previously been described in this setting. CLL is predominantly a disease of the elderly and affects men twice as often as women and hence only an estimated 2% of patients are females of childbearing age. We identified only five reported cases of CLL in pregnancy in the literature. We describe two additional cases, plus three other women with CLL dealing with pregnancy-related decisions. We review the literature and discuss proposals for management and issues that arise in this relatively uncommon occurrence. In contrast to many other haematological malignancies where longer remissions are typically associated with a lower risk of relapse, most patients with CLL who require treatment will ultimately relapse with current therapy. This complex setting requires careful consideration and well informed patients to assist with decisions related to pregnancy.
authors.affiliation: Department of Haematology, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia; Kolling Institute, University of Sydney, St Leonards, Sydney, NSW, Australia; Chronic Lymphocytic Leukaemia Australian Research Consortium (CLLARC), Sydney, NSW, Australia.
authors.forename: Nada
authors.initials: N
authors.lastname: Hamad
authors.forename: David
authors.initials: D
authors.lastname: Kliman
authors.forename: O Giles
authors.initials: OG
authors.lastname: Best
authors.forename: Melody
authors.initials: M
authors.lastname: Caramins
authors.forename: Mark
authors.initials: M
authors.lastname: Hertzberg
authors.forename: Robert
authors.initials: R
authors.lastname: Lindeman
authors.forename: Ric
authors.initials: R
authors.lastname: Porter
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Mulligan
mesh_terms: D000328:Adult; D001402:B-Lymphocytes / Q000473:pathology*; D003657:Decision Making; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis / Q000628:therapy*; D008218:Lymphocytosis / Q000175:diagnosis / Q000628:therapy*; D016742:Preconception Care / Q000379:methods; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult
keywords: chemotherapy; chronic lymphocytic leukaemia; monoclonal B-lymphocytosis; pregnancy; teratogenic