Acute leukemia during pregnancy: A single institutional experience with 17cases

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.