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Federación Mexicana de Ginecología y Obstetricia, A.C.

2023, Number 04

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Ginecol Obstet Mex 2023; 91 (04)

Acute promyelocytic leukemia during pregnancy: report of 17 cases from a developing country

Cabrera-García Á, Balderas-Delgado C, Ramírez-Lozada T, Valencia-Rocha UR, Madera-Maldonado E, Camargo-Romero E, Pérez-Samano D, Gallardo-Rodríguez AG, Olarte-Carrillo I, Ramos-Peñafie C

Language: Spanish
References: 23
Page: 241-248
PDF size: 221.90 Kb.


ABSTRACT

Objective: To collect cases attended in oncology centers in Mexico and to report successful treatments, with complete responses and complications around gestation.
Materials and Methods: Retrospective case series study including patients with pregnancy-associated acute promyelocytic leukemia attended in different hospitals in the metropolitan area of Mexico City between 1999 and 2021.
Results: Seventeen patients with pregnancy-associated acute promyelocytic leukemia were identified, with a median age of 23 years (14-40 years); 7 corresponded to mothers younger than 20 years. In relation to their social environment, 9 had low schooling, 12 were homebased and 13 had a partner at the time of conception. Finally, 11 were originally from an urban area. Patients seen between 1999-2010 were treated with interferon plus cytarabine (7 of 17) or by transfusion support and steroid (2 of 17), in 8 of the 17 cases treatment was initiated with tretinoin in combination with chemotherapy (daunorubicin) as induction therapy.
Conclusions: Treatment of pregnant patients and patients with acute promyelocytic leukemia represents a challenge due to thrombotic and hemorrhagic risk. Although the addition of tretinoin has modified the prognosis of patients with this leukemia, its indication in pregnant women remains controversial, especially because of the risk of teratogenicity.


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