Reversible foetal cerebral ventriculomegaly and cardiomyopathy under chemotherapy for maternal AML

Onkologie. 2009 Feb;32(1-2):40-3. doi: 10.1159/000184745. Epub 2009 Jan 20.

Abstract

Background: Leukaemia in pregnancy is a rare complication demanding a multidisciplinary approach and careful management to handle potential complications and cope with ethical dilemmas.

Patient and methods: We report on a patient with acute myeloid leukaemia (AML) relapse in 22 weeks of gestation who received chemotherapy with cytarabine and mitoxantrone, as well as fludarabine, cytarabine, idarubicin, and gemtuzumabozogamicin. We describe findings on regular ultrasound examinations and successful management of complications.

Results: The foetus developed signs of anthracycline-induced cardiomyopathy, transient cerebral ventriculomegaly, anaemia, and intrauterine growth restriction. The child was delivered by Caesarean section at 33 + 1 weeks of gestation. The newborn showed no congenital malformations.

Conclusion: This case report confirms that chemotherapy for treatment of AML can be applied in the second trimester of pregnancy under close and careful maternal and foetal monitoring.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Cardiomyopathies / chemically induced*
  • Cardiomyopathies / embryology
  • Cerebral Ventricles / abnormalities*
  • Cerebral Ventricles / drug effects
  • Female
  • Fetal Diseases / chemically induced*
  • Fetal Diseases / diagnosis
  • Humans
  • Leukemia, Myeloid, Acute / complications*
  • Leukemia, Myeloid, Acute / diagnosis
  • Leukemia, Myeloid, Acute / drug therapy*
  • Pregnancy
  • Pregnancy Complications, Neoplastic / drug therapy*
  • Pregnancy Complications, Neoplastic / prevention & control*
  • Treatment Outcome
  • Young Adult