title: A Complicated Case of Acute Promyelocytic Leukemia in the Second Trimester of Pregnancy Successfully Treated with All-trans-Retinoic Acid.
abstract: A 40-year-old female at 26-week gestation was diagnosed with acute promyelocytic leukemia (APL) after an abnormal prenatal lab workup showed pancytopenia. She was treated with all-trans-retinoic acid (ATRA), idarubicin, and dexamethasone. After day one of treatment, she developed differentiation syndrome, which was treated with dexamethasone. At 30-week gestation, she had preterm premature rupture of membranes and delivered by cesarean section because of the fetus' breech presentation. Despite ATRA's potential for teratogenicity, a viable infant was born without apparent anomalies. Postpartum, she underwent consolidation treatment with ATRA and arsenic trioxide (ATO). The patient continued ATRA therapy after delivery and is currently in remission.
authors.affiliation: The Commonwealth Medical College, 525 Pine Street, Scranton, PA 18510, USA.
authors.forename: Kanika
authors.initials: K
authors.lastname: Agarwal
authors.affiliation: The Commonwealth Medical College, 525 Pine Street, Scranton, PA 18510, USA.
authors.forename: Megha
authors.initials: M
authors.lastname: Patel
authors.affiliation: New Hope Cancer and Research Institute, 350 Vinton Avenue Suite 101, Pomona, CA 91767, USA.
authors.forename: Vandana
authors.initials: V
authors.lastname: Agarwal
references.citation: N Engl J Med. 1993 Jul 15;329(3):177-89
references.pmid: 8515790
references.citation: Blut. 1990 Nov;61(5):298-302
references.pmid: 2271776
references.citation: Hematology. 2007 Oct;12(5):415-8
references.pmid: 17852449
references.citation: Ann Oncol. 2010 May;21 Suppl 5:v266-73
references.pmid: 20555095
references.citation: Blood. 2009 Feb 26;113(9):1875-91
references.pmid: 18812465
references.citation: Br J Haematol. 1994 Mar;86(3):681-2
references.pmid: 8043456
references.citation: Cancer. 2005 Jul 1;104(1):110-7
references.pmid: 15912518
references.citation: Blood. 2000 Jan 1;95(1):90-5
references.pmid: 10607690
references.citation: Blood. 1992 Feb 1;79(3):543-53
references.pmid: 1732003
references.citation: Leukemia. 2000 Aug;14(8):1371-7
references.pmid: 10942231
references.citation: Int J Hematol. 2004 Jan;79(1):31-6
references.pmid: 14979475
references.citation: Blood. 1998 Oct 15;92(8):2712-8
references.pmid: 9763554
references.citation: J Clin Pharm Ther. 2008 Aug;33(4):331-8
references.pmid: 18613850
references.citation: Semin Oncol. 1989 Oct;16(5):388-96
references.pmid: 2678488
references.citation: Br J Haematol. 2010 Nov;151(3):209-20
references.pmid: 20735400
references.citation: Ann Intern Med. 1992 Aug 15;117(4):292-6
references.pmid: 1637024
references.citation: J Obstet Gynaecol Can. 2013 Mar;35(3):263-80
references.pmid: 23470115
references.citation: Blood. 2009 Jan 22;113(4):775-83
references.pmid: 18945964
references.citation: Leuk Lymphoma. 2000 Jun;38(1-2):195-8
references.pmid: 10811463
references.citation: Am J Hematol. 2009 Dec;84(12):830-41
references.pmid: 19844988
references.citation: Leukemia. 2001 Oct;15(10):1665-6
references.pmid: 11587228