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01-02-2018 | Review

Successful treatment of acute promyelocytic leukemia in pregnancy with single-agent all-trans retinoic acid

Authors: Cordula M. Nellessen, Viktor Janzen, Karin Mayer, Giulia Giovannini, Ulrich Gembruch, Peter Brossart, Waltraut M. Merz

Published in: Archives of Gynecology and Obstetrics | Issue 2/2018

Abstract

Purpose

The diagnosis of acute promyelocytic leukemia (APL) in pregnancy is an uncommon, life-threatening emergency. Choice of treatment and management of complications are challenging.

Methods

We report the case of a patient with diagnosis of APL at gestational age (GA) 24 + 4. We describe the interdisciplinary management during pregnancy and delivery and provide a 2-year follow-up. Existing reports on APL in pregnancy are summarized.

Results

Single-agent induction therapy with all-trans retinoic acid (ATRA) was started and resulted in normalization of blood cell counts after 32 days. Vaginal delivery of a healthy baby occurred at GA 34 + 4. Consolidation therapy consisted of four courses of ATRA and arsenic trioxide (ATO). Less than 100 cases of APL in pregnancy are published. Misdiagnosis as HELLP syndrome with fatal outcome may occur. Combination therapies (ATRA-plus anthracyclines) were used in the majority of reports.

Conclusions

Diagnosis and treatment of APL during pregnancy continues to be a challenge requiring interdisciplinary team work. Single-agent ATRA therapy may evolve as a safe and less-toxic treatment modality.

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Title: Successful treatment of acute promyelocytic leukemia in pregnancy with single-agent all-trans retinoic acid
Authors: Cordula M. Nellessen
Viktor Janzen
Karin Mayer
Giulia Giovannini
Ulrich Gembruch
Peter Brossart
Waltraut M. Merz
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 2/2018
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-017-4583-6

At a glance: The STEP trials

Springer Medicine

Successful treatment of acute promyelocytic leukemia in pregnancy with single-agent all-trans retinoic acid

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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