Acute leukemia in pregnancy: a single institution experience with 23 patients
Acute leukemia in pregnancy: a single institution experience with 23 patients
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DOI：
10.1080/10428194.2016.1222379
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发表时间：
2017-01-01
影响因子：
2.6
通讯作者：
Gangat, Naseema
中科院分区：
文献类型：
--
作者：
Farhadfar, Nosha;Cerquozzi, Sonia;Gangat, Naseema
妊娠期间急性白血病的治疗面临着巨大的挑战。在此，我们回顾一下23例被诊断为急性白血病患者的经验； 1962 年至 2016 年间在梅奥诊所怀孕期间。分别有 10 名 (43.4%)、7 名 (30.4%) 和 6 名 (26.2%) 患者在妊娠早期、中期和晚期被诊断出来。大约有 50% (n = 11) 发生治疗终止或自然流产。百分之五十 (2/4) 在妊娠早期或中期诊断并延迟化疗超过一周的患者在诱导治疗期间死亡。 11 名患者在怀孕期间接受化疗，导致 4 名胎儿流产和 7 名分娩（5 名足月分娩和 2 名早产）。未报告先天性畸形。十八名患者（78%）获得完全缓解。中位随访 55 个月后，7 名患者 (30%) 仍然活着。总之，我们对孕产妇和胎儿的结局进行了全面的描述，并对妊娠期间急性白血病的治疗进行了深入的了解。
Management of acute leukemia during pregnancy presents a considerable challenge. Herein, we review our experience of 23 patients diagnosed with acute leukemia; during pregnancy at the Mayo Clinic between 1962 and 2016. Ten (43.4%), seven (30.4%), and six (26.2%) patients were diagnosed in first, second, and third trimester, respectively. In approximately, 50% (n = 11) therapeutic terminations or spontaneous abortions occurred. Fifty percent (2/4) of patients diagnosed during either first or second trimester who delayed chemotherapy by greater than one week died during induction therapy. Eleven patients received chemotherapy while pregnant which led to four fetal losses and seven deliveries (five full-term and two preterm deliveries). No congenital malformations were reported. Eighteen patients (78%) achieved complete remission. At a median follow up of 55 months, seven patients (30%) remain alive. In summary, we provide a comprehensive description of maternal and fetal outcomes and insight into management of acute leukemia during pregnancy.