Consoli Ugo, Figuera Amalia, Milone Giuseppe, Meli Carmela Rita, Guido Giulia, Indelicato Francesco, Moschetti Gaetano, Leotta Salvatore, Tornello Antonella, Poidomani Massimo, Murgano Pamela, Pinto Valeria, Giustolisi Rosario
Chair and Division of Haematology with Bone Marrow Transplantation Unit, University of Catania, Catania, Italy.
Int J Hematol. 2004 Jan;79(1):31-6. doi: 10.1007/BF02983530.
Acute promyelocytic leukemia (APL) is characterized by onset at a young age and a life-threatening hemorrhagic diathesis, which is attributed to a disseminated intravascular coagulation (DIC)-like coagulopathy. The discovery of all-trans-retinoic acid has changed the course of APL treatment by reducing the onset of DIC and inducing a complete and durable remission in more than 90% of patients. The occurrence of APL during pregnancy is not a frequent event, but the management of these patients raises many therapeutic and ethical dilemmas and requires a careful clinical case evaluation of fetal and maternal risk, coagulation status, the parents' wishes, and therapeutic options. Here we describe 3 patients with APL diagnosed during pregnancy. Clinical data and the therapeutic approaches are presented. In the discussion, we analyze clinical decisions and therapeutic options and compare our cases with those found in the literature.
急性早幼粒细胞白血病（APL）的特点是发病年龄较轻且有危及生命的出血倾向，这归因于类似弥散性血管内凝血（DIC）的凝血病。全反式维甲酸的发现改变了APL的治疗进程，它减少了DIC的发生，并使超过90%的患者获得完全且持久的缓解。妊娠期间发生APL并不常见，但这些患者的管理引发了许多治疗和伦理困境，需要对胎儿和母亲的风险、凝血状态、父母的意愿以及治疗选择进行仔细的临床病例评估。在此，我们描述3例妊娠期间诊断为APL的患者。呈现了临床数据和治疗方法。在讨论中，我们分析了临床决策和治疗选择，并将我们的病例与文献中的病例进行了比较。
