New onset acute promyelocytic Leukemia during pregnancy: report of 2 cases

Cancer Biol Ther. 2019;20(4):397-401. doi: 10.1080/15384047.2018.1529122. Epub 2018 Nov 19.

Abstract

Acute promyelocytic leukemia (APL) is one of the most fatal hematological malignancies. APL during pregnancy is a rare comorbidity and can lead to adverse outcomes, such as maternal and/or fetal death, without timely and appropriate management. Medical management for APL during pregnancy remains challenging. We reported 2 patients with no regular prenatal visits who were diagnosed with APL during pregnancy. One presented with typical hematological abnormalities related to infection, while the other presented with intracranial hemorrhage, which is rare. Although supportive measures and chemotherapy were administered after APL was diagnosed, these two patients had completely different outcomes. The pregnancy outcomes of APL patients depend greatly on the timely diagnosis and appropriate management of the disease. Physicians should pay more attention to APL during pregnancy and thus may save more maternal and fetal lives. Further study of the management of APL during pregnancy is warranted. Abbreviations: AML: acute myeloid leukemia; APL: acute promyelocytic leukemia; WBC: white blood cell; RBC: red blood cell; Hb: hemoglobin; PT: prothrombin time; TT: thrombin time; APTT: activated partial thromboplastin time; TP: total protein; ALB: albumin; AST: aspartate transaminase; ALT: alanine aminotransferase; LDH: lactate dehydrogenase; ATRA: all-trans retinoic acid; ICH: intracranial hemorrhage; DIC: disseminated intravascular coagulation.

Keywords: ATRA; acute promyelocytic leukemia; infection; intracranial hemorrhage; management; pregnancy; pregnancy outcome.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age of Onset
  • Antineoplastic Agents / therapeutic use
  • Female
  • Humans
  • Leukemia, Promyelocytic, Acute / drug therapy
  • Leukemia, Promyelocytic, Acute / pathology*
  • Pregnancy
  • Pregnancy Complications, Neoplastic / drug therapy
  • Pregnancy Complications, Neoplastic / pathology*
  • Prognosis
  • Tretinoin / therapeutic use*
  • Young Adult

Substances

  • Antineoplastic Agents
  • Tretinoin

Grants and funding

This work was supported by National Natural Science Fund of China under Grant No. 81471419 and Natural Science Fund of Tianjin Municipal Science and Technology Commission under Grant No. 16JCYBJC26400.