The combination of acute leukemia and pregnancy is infrequent. It is estimated to occur in less than 1 in 75,000 pregnancies. Maternal and fetal outcomes have improved substantially in recent years. In general, multi-agent chemotherapy is given as soon as the diagnosis of leukemia is established, even if it is in the first trimester. There are two important considerations in the management of a patient with leukemia during pregnancy, the mother who needs optimal cancer therapy and the developing fetus who could potentially be affected by the disease and/or the teratogenicity of antineoplactic agents. Vaginal delivery is preferable, and caesarian section is reserved for obstetrical indications only.
PelegD.Ben-AmiM.1998. Lymphoma and leukemia complicating pregnancy. Obstet. Gynecol. Clin. North Am.25:365.
2.
CaligiuriM.A.MayerR.J.1989. Pregnancy and leukemia. Semin. Oncol.16:338.
3.
HurleyT.J.McKinnellJ.V.IraniM.S.2005. Hematologic malignancies in pregnancy. Obstet. Gynecol. Cli. North Am.32:595.
4.
SifakisS.PharmakidesG.2000. Anemia in pregnancy. Ann. NY Acad. Sci.900:125.
5.
GabbeG.NiebylJ.R.SimpsonJ.L.2002. Normal and problem pregnancies. Neoplastic diseases57:1286.
6.
ReynosoE.E.ShepherdF.A.MessnerH.A.FarquharsonH.A.GarveyM.B.BakerM.A.1987. Acute leukemia during pregnancy. The Toronto leukemia study group experience with long-term follow up of children exposed in utero to chemotherapeutic agents. J. Clin. Oncol.5:1098.
7.
CunninghamF.G.MacDonaldP.C.GantN.F.LevenoK.J.GilstrapL.C.HankinsG.D.V.ClarkS.L.2001. Williams Obstetrics. Neoplastic Diseases57:1286.
8.
AntoneliN.M.DottersD.J.KatzV.L.KullerJ.A.1996. Cancer in pregnancy: A review of the literature. Part II Obstet. Gynecol. Surv.51:135.
9.
ChelghoumY.VeyN.RaffouxE.HuggetF.PigneuxA.WitzB.PautasC.de BottonS.GuyotatD.LioureB.FeguexN.GarbanF.SaadH.ThomasX.2005. Acute leukemia during pregnancy report of 37 patients and literature review. Cancer104:110.
10.
KwanM.L.MetayerC.CrouseV.BufferP.2006. Maternal illness and drug/medication use during the period surrounding pregnancy and risk of childhood leukemia among offspring. Am. J. Epidemol.11:1.
11.
AvilesA.NeriN.2001. Hematological malignancies and pregnancy. A final report of 84 children who received chemotherapy in utero. Clin. Lymph.2:173.
12.
FassasA.KartalisG.KlearhouN.TsatalasK.SinacosZ.MantalenakisS.1984. Chemotherapy for acute leukemia during pregnancy. Five case reports. Nouv. Rev. Fr. Hematol.26:19.
13.
IsemingerK.A.LewisM.A.1998. Ethical challenges in treating mother and fetus when cancer complicates pregnancy. Obstet. Gynecol. Clin. North Am.25:273.
14.
AliR.OzkalemkasF.OzcekiT.2003. Maternal and fetal outcomes in pregnancy complicated with acute leukemia: A single institutional experience with 10 pregnancies at 16 years. Leuk. Res.5:381.
15.
SuW.L.LiuJ.Y.KaoW.Y.2003. Management of pregnancy-associated acute leukemia. Eur. J. Gynaecol. Oncol.24:251.
