A successful multidisciplinary approach for treatment and for preserving the reproductive potential in a rare case of acute lymphocytic leukemia during pregnancy

Gynecol Endocrinol. 2019 Feb;35(2):115-118. doi: 10.1080/09513590.2018.1498833. Epub 2018 Sep 4.

Abstract

Leukemia in pregnancy is a rare condition with the prevalence of 1 in 75,000-100,000 pregnancies. In this case report, we present a successful multidisciplinary management strategy for treatment and for preserving the reproductive potential in a rare case of acute lymphocytic leukemia (ALL) during pregnancy. Several complex challenges existed and necessitated a multidisciplinary approach with strong coordination and collaboration between oncologists, gynecologists, reproductive cryobiologists, obstetricians, and neonatologists in order to improve the maternal and fetal outcome. Pregnancy in the second trimester is neither a contraindication for ALL treatment nor for emergency fertility preservation via ovarian tissue extraction and further cryopreservation.

Keywords: Leukemia; artificial ovary; autotransplantation; oncofertility; ovarian tissue cryopreservation; pregnancy.

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cesarean Section
  • Consolidation Chemotherapy / methods
  • Cryopreservation / methods*
  • Female
  • Fertility Preservation / methods*
  • Fetal Growth Retardation
  • Humans
  • Induction Chemotherapy / methods
  • Infant, Newborn
  • Male
  • Methotrexate / therapeutic use
  • Ovariectomy / methods*
  • Ovary*
  • Patient Care Team
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Pregnancy
  • Pregnancy Complications, Neoplastic / therapy*

Substances

  • Methotrexate