MANAGEMENT OF ACUTE-LEUKEMIA DURING PREGNANCY - FROM THE RESULTS OF ANATIONWIDE QUESTIONNAIRE SURVEY AND LITERATURE SURVEY

In March, 1993, a questionnaire was sent to 362 gynecological and obst etric offices of national, prefectural and municipal hospitals and pri vate university hospitals with 250 beds or more. Answers were collecte d from 260 institutions. Thus, this study analyzed 39 patients with ac ute leukemia during pregnancy collected by the questionnaires survey a nd 64 cases reported in the Japanese literatures during 1975-1993 (tot al 103 patients). The weeks of pregnancy were defined as the Ist (<15t h week), 2nd (16th-27th meek), and 3rd (>28th week) trimesters. The ti me of dagnosis of leukemia during pregnancy changed from 25% in the 2n d trimester and 62% in the 3rd trimester during 1975-1984 to 39% and 4 8% after 1985, respectively. After 1985, the remission rate was 72% in the questionnaire group and 75% in the group from literatures. There was no statistical difference. The 50% survival period was 12 months i n the group during 1975-1984, but 25 months in the group after 1985. T he survival was significantly longer in the patients whose induction t herapy was started before delivery than in those treated after deliver y. The results suggest that the treatment for acute leukemia during pr egnancy should be initiated as soon as possible after the diagnosis of leukemia, with carefully selected regimens. It is important that the time of delivery should be selected considering the maternal and fetal conditions after consultation with an obstetrician.