Abstract
The management of pregnant women with acute promyelocytic leukemia (APL) is a challenge with limited evidence-based information available. We are reporting a series of 14 consecutive pregnant women with APL who were registered in the PETHEMA Data Centre between 1996 and 2012. APL was diagnosed during early pregnancy in five women, late pregnancy in seven, and two additional patients after delivery in an extremely poor clinical condition (pulmonary and cerebral hemorrhage). Eleven of the 12 patients eligible for induction therapy with all-trans retinoic acid and idarubicin achieved complete remission (CR 92 %) and are still in the first CR. All early pregnancies ended in abortion (four induced and one spontaneous), with four of them achieving CR. Eight of nine women in late pregnancy delivered a healthy infant (six cesarean section and two vaginal delivery). All eight babies developed normally. Our results confirm a high cure rate for pregnant women with APL who received all-trans retinoic acid and idarubicin for induction therapy, and an excellent outcome for babies when the disease is diagnosed during late pregnancy.
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Acknowledgments
The authors thank all participating institutions and clinicians in the PETHEMA studies. This work was supported in part by Cooperative Research Thematic Network Grant RD12/0036/014 (Instituto de Salud Carlos III and European Regional Development Fund).
Author contribution
M.A.S. conceived the study and analyzed and interpreted the data; M.A.S., P.M., A.P., and A.P. wrote the paper; M.F.C, J.D-M., S.J., I.F., P.F., J.G-C., J.D.G., P.H., E.L., T.O., R.R., O.S., and M.J.S. included data of patients treated in their institutions, reviewed the manuscript, and contributed to the final draft.
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The authors declare no competing financial interests.
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Sanz, M.A., Montesinos, P., Casale, M.F. et al. Maternal and fetal outcomes in pregnant women with acute promyelocytic leukemia. Ann Hematol 94, 1357–1361 (2015). https://doi.org/10.1007/s00277-015-2372-5
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DOI: https://doi.org/10.1007/s00277-015-2372-5