[Acute myeloid leukemia and pregnancy]

ABSTRACT

This is a rare clinical entity estimated to affect one in 100,000 pregnancies. The challenge is to provide a beneficial therapeutic regimen for the mother while limiting toxic effects to the fetus. Patient 27 year pregnant by 32 weeks gestation, presents a complete bone marrow failure syndrome. Laboratory tests have objectified an acute myelogenous leukemia type 2. The course of action was the initiation of vaginal delivery under cover of red cell transfusion and platelet giving birth to a healthy newborn. Chemotherapy as AML03 protocol allowed a complete remission of the disease. Pregnancy does not affect the development of acute myelogenous leukemia. The rate of remission and survival rates at 6 and 12 months were comparable among women of childbearing age, whether they are pregnant or not. The treatment is the same as that used in patients not pregnant. Leukemia, it has consequences on pregnancy. The number of delayed intrauterine growth, miscarriage and spontaneous preterm birth is higher in patients untreated. Hematological addition treatments, beneficial for the mother, are teratogenic. During the first trimester, termination of pregnancy should be discussed due to effects of chemotherapy on the fetus. While in the second or third trimester may be administered without interruption of pregnancy