Maternal and Fetal Outcomes of Acute Leukemia in Pregnancy: A Retrospective Study of 52 Patients.
Maternal and Fetal Outcomes of Acute Leukemia in Pregnancy: A Retrospective Study of 52 Patients.
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妊娠期急性白血病的母婴结局：52 名患者的回顾性研究
DOI：
10.3389/fonc.2021.803994
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发表时间：
2021
影响因子：
4.7
通讯作者：
Wu D
中科院分区：
文献类型：
--
作者：
Wang P;Yang Z;Shan M;Lu S;Zhang L;Li S;Hu S;Tian H;Xu Y;Wu D
怀孕期间的急性白血病是一种罕见的疾病，关于母亲和胎儿的管理和结果有限，我们回顾性地分析了2013年1月收集的52例P-AL患者的特征，妊娠结局以及孕妇和新生儿到2020年12月在我们的中心。堕胎/分娩后的化学疗法（非培训队列）。 ，而在暴露的队列中，有19个婴儿（73.1％）出生于胎儿胎儿的安全性，暴露的队列中有7例患者接受了低剂量的化学疗法，一名患者接受了全反式视黄酸（ATRA），而一名患者仅接受诱导疗法的患者，仅接受皮质类固醇。完全缓解（CR）率（p = 0.041），该组的患者接受了HSCT（P = 0.010）的速度（P = 0.010）与及时的化学疗法的患者相比，非X型队列中的化学疗法经历了更高的死亡率趋势（P = 0.191）。曝光和非群体的总体生存率（OS）和无疾病的生存率（DFS）分别为49.1％和57.8％。如果没有畸形或智力障碍，我们的研究表明，妊娠中期的P-AL患者可能会在堕胎后接受化学疗法。妊娠中期或延迟的化学疗法可能会降低患者的诱导疗法和存活率，但HSCT可以提高预后。
Acute leukemia during pregnancy (P-AL) is a rare disease with limited data regarding the management and outcomes of mothers and fetuses. We retrospectively analyzed the characteristics, pregnancy outcomes and maternal and neonatal prognoses of 52 patients with P-AL collected from January 2013 to December 2020 in our center. Seventeen (32.7%) patients received chemotherapy during pregnancy (exposed cohort), while 35 (67.3%) received chemotherapy after abortion/delivery (nonexposed cohort). Twenty-six (50.0%) pregnancies ended with abortion, and 26 (50.0%) babies were born through spontaneous delivery or cesarean section. Seven infants (26.9%) were born in the exposed cohort, while 19 infants (73.1%) were born in the nonexposed cohort. Fetuses in the exposed cohort had lower gestational ages (P=0.030) and birth weights (P=0.049). Considering the safety of the fetus, seven patients in the exposed cohort received low-dose chemotherapy, one patient received all-trans retinoic acid (ATRA) and one patient only received corticosteroids as induction therapy. Patients received low-dose chemotherapy as induction therapy had a lower complete remission (CR) rate (P=0.041), and more patients in this group received HSCT (P=0.010) than patients received intensive chemotherapy. Patients who delayed chemotherapy in the nonexposed cohort experienced a trend toward a higher mortality rate than patients who received timely chemotherapy (P=0.191). The CR (P = 0.488), OS (P=0.655), and DFS (P=0.453) were similar between the exposed and nonexposed cohorts. Overall, the 4-year overall survival (OS) and disease-free survival (DFS) rates were estimated at 49.1% and 57.8%, respectively. All newborns were living, without deformities, or developmental and intellectual disabilities. Our study indicated that P-AL patients in the first trimester might tend to receive chemotherapy after abortion. Both the status of disease and patients’ willingness should be taken into consideration when clinicians were planning treatment strategies in the second or third trimester. Low-dose or delayed chemotherapy might decrease the efficacy of induction therapy and survival rate of patients, but HSCT could improve the prognosis.
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影响因子：
2.6
作者：
Farhadfar, Nosha;Cerquozzi, Sonia;Gangat, Naseema
通讯作者：
Gangat, Naseema
影响因子：
8.8
作者：
Nulman I;Laslo D;Fried S;Uleryk E;Lishner M;Koren G
通讯作者：
Koren G
影响因子：
3.5
作者：
Sanz, Miguel A.;Montesinos, Pau;Perales, Alfredo
通讯作者：
Perales, Alfredo
DOI：
10.3816/clm.2001.n.023
发表时间：
2001-12-01
期刊：
CLINICAL LYMPHOMA
影响因子：
--
作者：
Avilés, A;Neri, N
通讯作者：
Neri, N
成人急性髓性白血病和复发性遗传异常的发病率、生存率和危险因素：2001-2013 年监测、流行病学和最终结果 (SEER) 数据库分析
影响因子：
2.4
作者：
Song, Xiaolu;Peng, Ye;Lan, Jianping
通讯作者：
Lan, Jianping