ACUTE MONOCYTIC LEUKEMIA (FAB M5) INVOLVING THE PLACENTA ASSOCIATED WITH DELIVERY OF A HEALTHY INFANT - CASE-REPORT AND DISCUSSION

Acute leukemia seldom presents during pregnancy, and though pregnancy may not affect the course of leukemia, fetal complications and materna l mortality are high. Documented placental involvement is rare, as are metastases to the fetus. Comprehensive review of the literature revea ls only a few reports of maternal or fetal leukemia with placental inv olvement. We encountered a case of a 45-year-old woman who presented a t 29 weeks' gestation with acute monocytic leukemia with t(9;11). She was managed conservatively. Labor was induced at 33 weeks, with delive ry of a healthy male infant prior to induction chemotherapy. The baby remained well at 18 months of age. The placenta showed isolated microi nfarcts and an infiltrate in the basal plate of leukemic cells confirm ed by immunohistochemistry. No invasion into chorionic villi was seen. Little is known about the biological significance of placental involv ement and inherent defense mechanisms of the placenta in maternal canc ers. Therefore, detailed histopathologic examination of the placenta s hould always be performed and reported in leukemic patients, regardles s of fetal outcome.