The Management of Acute Promyelocytic Leukemia Presenting During Pregnancy

Dominic J. Culligan , Luke Merriman , Jonathan Kell , Jane Parker , Jelena V. Jovanovic , Norman Smith , David Grimwade
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引用次数: 32

Abstract

Acute promyelocytic leukemia is recognized to occur infrequently during pregnancy. The prognosis is good for acute promyelocytic leukemia with modern therapy including treatment with all-trans-retinoic acid that specifically targets the causative retinoic acid receptor (PML-RAR)α oncoprotein; however, the management of this disease in pregnancy is complex. This is because there are a number of possible treatment strategies that have varying implications for the mother and fetus. We describe a recent experience relating to 3 consecutive cases arising in the United Kingdom that demonstrates the different therapeutic decisions that can be taken and the various outcomes that can occur during pregnancy. In each case, treatment response was subject to stringent monitoring by real-time quantitative polymerase chain reaction for the PML-RARA fusion transcript. We have reviewed the available literature and, when possible, we have outlined the treatment strategies available for each stage of pregnancy.

妊娠期出现急性早幼粒细胞白血病的处理
急性早幼粒细胞白血病是公认的罕见发生在怀孕期间。急性早幼粒细胞白血病的现代治疗包括靶向致病性视黄酸受体(PML-RAR)α癌蛋白的全反式视黄酸治疗,预后良好;然而,这种疾病在妊娠期的管理是复杂的。这是因为有许多可能的治疗策略对母亲和胎儿有不同的影响。我们描述了最近在英国出现的3个连续病例的经验,这些病例展示了怀孕期间可以采取的不同治疗决定和可能发生的各种结果。在每种情况下,通过实时定量聚合酶链反应严格监测PML-RARA融合转录物的治疗反应。我们已经回顾了现有的文献,并在可能的情况下,我们概述了每个妊娠阶段可用的治疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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