Positive Health Online

Abstract

VERMA and COLLEAGUES, 1. a Department of Radiation Oncology , University of Nebraska Medical Center , Omaha , NE , USA; 2. b Department of Internal Medicine , University of Tennessee Health Science Center , Memphis , TN , USA; 3. c Department of Medicine , University of Pittsburgh Medical Center - Mercy Hospital , Pittsburgh , PA , USA; 4. d Department of Internal Medicine , Reading Health System , West Reading , PA , USA; 5. e Department of Internal Medicine , Division of Hematology/Oncology, University of Nebraska Medical Center , Omaha , NE , USA conducted a systematic review of acute promyelocytic leukemia (APL) in pregnancy.

Background

The outcomes of acute promyelocytic leukemia (APL) in pregnancy are largely unknown.

Methodology

The MEDLINE database was systematically searched to obtain 43 articles with 71 patients with new-onset APL during pregnancy.

Results

Induction therapy included various regimens of all-trans retinoic acid (ATRA), cytarabine, and anthracycline and resulted in a complete remission rate of 93%. Obstetric and foetal complications included pre-term deliveries (46%), spontaneous/therapeutic abortion/intrauterine death (33.3%) and other neonatal complications (25.9%). Mothers diagnosed in the first trimester were more likely to experience obstetric (p < 0.01) and foetal (p < 0.01) complications.

Conclusion

To our knowledge, this is the largest systematic review of APL in pregnancy. The vast majority of APL patients in pregnancy may achieve remission with initial induction therapy. APL or its therapy in pregnancy, however, is associated with a high risk of foetal and obstetrical complications. The results of our study may help in patient counselling and informed decision-making.

References

Verma V1, Giri S2, Manandhar S3, Pathak R4, Bhatt VR5. Acute promyelocytic leukemia during pregnancy: a systematic analysis of outcome. Leuk Lymphoma.57(3):616-22. 2016. doi: 10.3109/10428194.2015.1065977. Epub Jul 28 2015.