Clinical features and prognosis of acute leukemia in pregnancy: an analysis of 39 cases / 白血病·淋巴瘤

ABSTRACT

Objective To investigate the clinical features and prognosis of patients with acute leukemia (AL) in pregnancy.Methods The clinical data of 39 cases of acute leukemia in pregnancy at the First Affiliated Hospital of Zhengzhou University from January 2010 to April 2017 were collected.The clinical characteristics and prognosis were analyzed retrospectively.Results Except one case diagnosed before pregnancy,the incidence rates of AL in early,middle and late stage of pregnancy were 23.7 ％ (9/38),52.6 ％ (20/38) and 23.7 ％ (9/38),respectively.31 patients received chemotherapy and the complete response (CR) rates of AL patients in early,middle and late stage of pregnancy were 71.4 ％ (5/7),94.1％ (16/17),and 100.0 ％ (7/7),respectively.Among all the cases,31 patients received a miscarriage or induction of labor,and 8 cases had live births delivered by cesarean section.Twenty-two patients had abnormal karyotypes,which was mainly related to specific chromosomal rearrangement.Acute myeloid leukemia (AML) patients expressed high levels of CD117,CD13,CD33,and CD38,and acute lymphoblastic leukemia (ALL) patients had high expression of CD19,CD38,CD22,cCD79a,and CD58.After induction therapy,10 cases got positive minimal residual disease (MRD),7 of which achieved CR.After that,4 cases recurred,and 7 cases died in total.On the other hand,all the 19 MRD-negative patients achieved CR.Then,5 cases recurred,and 9 cases died intotal.In all patients,29 were AML while the other 10 were ALL,the CR rates in AML and ALL were 95.7 ％ (22/23) and 75.0 ％ (6/8),and the 1-year and 2-year survival rate were 53.1％ and 26.4 ％,respectively.The survival rate of AML patients was higher than that of ALL patients.Conclusions The clinical characteristics of AL patients in pregnancy are complicated and comprehensive treatment is needed.MDR is an important indicator of prognosis,and the prognosis of ALL is worse than that of AML.