title: Acute leukemia in pregnancy: a single institution experience with 23 patients.
abstract: Management of acute leukemia during pregnancy presents a considerable challenge. Herein, we review our experience of 23 patients diagnosed with acute leukemia; during pregnancy at the Mayo Clinic between 1962 and 2016. Ten (43.4%), seven (30.4%), and six (26.2%) patients were diagnosed in first, second, and third trimester, respectively. In approximately, 50% (n = 11) therapeutic terminations or spontaneous abortions occurred. Fifty percent (2/4) of patients diagnosed during either first or second trimester who delayed chemotherapy by greater than one week died during induction therapy. Eleven patients received chemotherapy while pregnant which led to four fetal losses and seven deliveries (five full-term and two preterm deliveries). No congenital malformations were reported. Eighteen patients (78%) achieved complete remission. At a median follow up of 55 months, seven patients (30%) remain alive. In summary, we provide a comprehensive description of maternal and fetal outcomes and insight into management of acute leukemia during pregnancy.
authors: a Division of Hematology , Mayo Clinic College of Medicine , Rochester , MN , USA.
authors: Nosha
authors: N
authors: Farhadfar
authors: a Division of Hematology , Mayo Clinic College of Medicine , Rochester , MN , USA.
authors: Sonia
authors: S
authors: Cerquozzi
authors: a Division of Hematology , Mayo Clinic College of Medicine , Rochester , MN , USA.
authors: Michael R
authors: MR
authors: Hessenauer
authors: a Division of Hematology , Mayo Clinic College of Medicine , Rochester , MN , USA.
authors: Mark R
authors: MR
authors: Litzow
authors: a Division of Hematology , Mayo Clinic College of Medicine , Rochester , MN , USA.
authors: William J
authors: WJ
authors: Hogan
authors: a Division of Hematology , Mayo Clinic College of Medicine , Rochester , MN , USA.
authors: Louis
authors: L
authors: Letendre
authors: a Division of Hematology , Mayo Clinic College of Medicine , Rochester , MN , USA.
authors: Mrinal M
authors: MM
authors: Patnaik
authors: a Division of Hematology , Mayo Clinic College of Medicine , Rochester , MN , USA.
authors: Ayalew
authors: A
authors: Tefferi
authors: a Division of Hematology , Mayo Clinic College of Medicine , Rochester , MN , USA.
authors: Naseema
authors: N
authors: Gangat
mesh_terms: D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor; D003131:Combined Modality Therapy; D060830:Consolidation Chemotherapy; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000628:therapy*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000628:therapy*; D011256:Pregnancy Outcome; D012074:Remission Induction; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor
keywords: Acute leukemia; chemotherapy; pregnancy