Maternal and fetal outcomes in pregnant women with acute promyelocytic leukemia
Maternal and fetal outcomes in pregnant women with acute promyelocytic leukemia
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DOI：
10.1007/s00277-015-2372-5
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发表时间：
2015-08-01
影响因子：
3.5
通讯作者：
Perales, Alfredo
中科院分区：
文献类型：
--
作者：
Sanz, Miguel A.;Montesinos, Pau;Perales, Alfredo
由于现有的循证信息有限，对患有急性早幼粒细胞白血病（APL）的孕妇进行管理是一项挑战。我们报告了 1996 年至 2012 年间在 PETHEMA 数据中心登记的一系列连续 14 名患有 APL 的孕妇。其中 5 名女性在妊娠早期诊断出 APL，7 名女性在妊娠晚期诊断出 APL，另外还有 2 名患者在分娩后临床状况极差（肺出血和脑出血）时被诊断出 APL。符合全反式维A酸和伊达比星诱导治疗的 12 名患者中，有 11 名患者实现完全缓解（CR 92%），且仍处于首次 CR 状态。所有早期妊娠均以流产告终（四例人工流产，一例自然流产），其中四例达到 CR。九名妊娠晚期妇女中有八名产下健康婴儿（六名剖腹产，两名阴道分娩）。所有八个婴儿均发育正常。我们的结果证实，接受全反式维A酸和伊达比星诱导治疗的APL孕妇的治愈率很高，并且在妊娠晚期诊断出该疾病时，婴儿的预后也很好。
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.