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[Treatment for acute promyelocytic leukemia during pregnancy]

Authors :
V V, Troitskaia
E N, Parovichnikova
A N, Sokolov
A V, Kokhno
S A, Makhinia
G M, Galstian
T S, Konstantinova
L A, Mazurok
I G, Goriachok
A V, Korobkin
M A, Liubshenko
O A, Latyshkevich
A V, Zvereva
M A, Kurtser
V G, Savchenko
Source :
Terapevticheskii arkhiv. 85(10)
Publication Year :
2014

Abstract

To study the experience in managing patients with acute promyelocytic leukemia (APL) diagnosed in different periods of pregnancy.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.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.APL treatment in pregnant women, which is aimed at saving two lives, is effective and reasonable.

Details

ISSN :
00403660
Volume :
85
Issue :
10
Database :
OpenAIRE
Journal :
Terapevticheskii arkhiv
Accession number :
edsair.pmid..........e2c8ab611a398c1300380d28c36d370f