Pregnancy during therapy for childhood acute lymphoblastic leukemia: two case reports and a review of the literature

Journal of Pediatric Hematology/oncology
S K Bergstrom, A J Altman

Abstract

The incidence and consequences of pregnancy during therapy for childhood acute lymphoblastic leukemia (ALL) are largely unknown. To explore the issues involved in this complication of ALL treatment, two recent cases are presented. Two 15-year-old girls with "high risk" ALL became pregnant while receiving maintenance therapy. In one case, the patient experienced a spontaneous abortion at approximately 5 to 6 weeks gestation. The patient completed maintenance therapy and is in remission 8 months after the end of treatment. The second patient, known to be non-compliant during therapy, was found to be 5 months pregnant at the end of maintenance therapy. She developed HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count), was induced at approximately 34 weeks, and delivered an apparently normal baby girl. Both the patient and her baby continue to do well 10 months after delivery. A variety of factors may influence the incidence of pregnancy during ALL therapy. Gonadal function, which is likely to return to normal during maintenance therapy, may also be affected by alterations in the dose intensity of treatment. Social factors may also alter the incidence of pregnancy. Adverse effects on the fetus are more likely...Continue Reading

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Citations

Jul 27, 2001·British Journal of Haematology·V H van der VeldenJ J van Dongen
Aug 2, 2012·Birth Defects Research. Part A, Clinical and Molecular Teratology·Brady P SeligJohn J Mulvihill
Oct 22, 2009·American Journal of Hematology·Tina RizackJorge Castillo
Jan 11, 2013·International Journal of Immunopathology and Pharmacology·L Del PupM Berretta

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