Терапевтический архив (Oct 2013)

Treatment for acute promyelocytic leukemia during pregnancy

  • V V Troitskaia,
  • E N Parovichnikova,
  • A N Sokolov,
  • A V Kokhno,
  • S A Makhinia,
  • G M Galstian,
  • T S Konstantinova,
  • L A Mazurok,
  • I G Goriachok,
  • A V Korobkin,
  • M A Liubchenko,
  • O A Latyshkevich,
  • A V Zvereva,
  • M A Kurtser,
  • V G Savchenko

Journal volume & issue
Vol. 85, no. 10
pp. 56 – 63

Abstract

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AIM: To study the experience in managing patients with acute promyelocytic leukemia (APL) diagnosed in different periods of pregnancy/MATERIAL AND METHODS: Nine women with APL were treated in 1998-2013. When APL was diagnosed in the first trimester of pregnancy, the latter was terminated (n=1); when its diagnosis was made in the second trimester, chemotherapy (CT) followed by delivery (D) was performed (n=3); when it was done in the third trimester, D followed by CT was done in relation to gestational age (n=2) or these were performed at a later gestational age (n=1). APL was treated in 5 and 1 patients according to the AIDA protocol and the 7+3 plus ATRA one, respectively/RESULTS: All the patients with APL achieved remission after the first cycle of induction CT; 5 of the 6 patients did at the moment of delivery; one patient underwent emergency delivery during cytopenia after the cycle. The gestational age at delivery after CT was 34 (34-40) weeks. Spontaneous term labor occurred in 2 patients at an obstetric hospital. Cesarean section was made in 4 of the 6 patients. All babies were born alive, healthy, and without developmental abnormalities. Their age at the time of analyzing the results was 2.5 months to 15 years. Four of the 9 patients are presently alive. Late recurrences occurred in 3 (33%) patients. The median overall survival is 26 (0.25-128) months; the median relapse-free survival is 17.5 (0-127) months/CONCLUSION: APL treatment in pregnant women, which is aimed at saving two lives, is effective and reasonable.

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