We reviewed the medical records of 17 consecutive patients with concomitant
acute leukemia and pregnancy seen at our institution over a 37-year period
. Fifteen cases each were either newly diagnosed or classified as acute mye
loid leukemia (AML). Seven diagnoses (41%) occurred in the first, 7 (41%) i
n the second, and 3 (18%) in the third trimester. In general, nine patients
received chemotherapy while pregnant-eight in the second trimester and one
in the third. The overall complete remission rate among the 13 patients wi
th newly diagnosed AML was 69%, compared with 86% in those who were pregnan
t during chemotherapy. Long-term survival was documented in five of the nin
e complete responders. Three of four patients who elected to delay treatmen
t until after delivery died within days of starting chemotherapy. Unintenti
onal fetal loss occurred in four patients (29%), including two without expo
sure to chemotherapy. There were no instances of congenital malformation. T
he results from the current study confirm that pregnancy per se may not aff
ect the outcome of chemotherapy in AML. In addition, it is suggested that t
reatment delays may compromise maternal outcome without improving pregnancy
outcome.