Eskander Ramez N, Tarsa Maryam, Herbst Kenneth D, Kelly Thomas F
Department of Obstetrics and Gynecology, University of California San Diego, San Diego, California, USA.
J Obstet Gynaecol Res. 2011 Nov;37(11):1731-3. doi: 10.1111/j.1447-0756.2011.01591.x. Epub 2011 Jul 25.
Leukemia during pregnancy is rare, posing a complex series of questions, including appropriate therapy and maternal counseling. Management of chronic myelocytic leukemia (CML) during pregnancy is limited. Our patient presented at 30 weeks' gestation with anemia, leukocytosis, and a non-productive cough. Polymerase chain reaction performed on a peripheral blood sample confirmed presence of the breakpoint cluster region-Abl1 chromosomal translocation and the diagnosis of CML. Therapy included acute leukocytapheresis, followed by α-interferon and imatinib mesylate. The patient responded to treatment and delivered a viable female infant at term weighing 2613 g. Continued imatinib mesylate chemotherapy post-delivery resulted in complete clinical remission. Successful antepartum management of newly diagnosed CML is possible utilizing leukocytapheresis, α-interferon and, more recently, imatinib mesylate. Definitive treatment should not be delayed due to pregnancy.
孕期白血病较为罕见，会引发一系列复杂问题，包括恰当的治疗及对孕妇的咨询指导。孕期慢性粒细胞白血病（CML）的管理方法有限。我们的患者在妊娠30周时出现贫血、白细胞增多和干咳症状。对外周血样本进行的聚合酶链反应证实存在断裂点簇集区-Abl1染色体易位，从而确诊为CML。治疗方法包括急性白细胞去除术，随后使用α干扰素和甲磺酸伊马替尼。患者对治疗有反应，并足月产下一名体重2613克的存活女婴。产后继续使用甲磺酸伊马替尼化疗实现了完全临床缓解。利用白细胞去除术、α干扰素以及最近使用的甲磺酸伊马替尼，对新诊断的CML进行成功的产前管理是可行的。不应因怀孕而延迟确定性治疗。
