妊娠期急性髓系白血病

Acute myeloid leukemia in the pregnant patient.

作者信息

Thomas Xavier

机构信息

Hospices Civils de Lyon, Hematology Department, Lyon-Sud Hospital, Pierre Bénite, France.

出版信息

Eur J Haematol. 2015 Aug;95(2):124-36. doi: 10.1111/ejh.12479. Epub 2015 Apr 18.

Abstract

Although acute myeloid leukemia (AML) mostly occurs in older patients, it could be seen in women of childbearing age. It is therefore not surprising that in some patients, the management of AML will be complicated by a coexistent pregnancy. However, the association of leukemia and pregnancy is uncommon. Its incidence is estimated to be 1 in 75,000-100,000 pregnancies. During pregnancy, most leukemias are acute: two-thirds are myeloid and one-third are lymphoblastic. There is no standard approach for this clinical dilemma, in part because of variables such as the type of AML, the seriousness of the symptoms, and the patient's personal beliefs. In many cases, the diagnostic workup has to be altered because of the pregnancy, and often available treatments have varying risks to the fetus. While chemotherapy is reported to have some risks during the first trimester, it is admitted that it can be administered safely during the second and the third trimesters.

摘要

虽然急性髓系白血病(AML)大多发生于老年患者,但育龄期女性也可能发病。因此,在一些患者中,AML的治疗会因合并妊娠而变得复杂也就不足为奇了。然而,白血病与妊娠的关联并不常见。其发病率估计为每75,000 - 100,000次妊娠中有1例。在妊娠期,大多数白血病为急性白血病:其中三分之二为髓系白血病,三分之一为淋巴细胞白血病。对于这种临床困境,尚无标准的处理方法,部分原因是存在诸如AML类型、症状严重程度以及患者个人信念等变量。在许多情况下,由于妊娠,诊断检查必须做出改变,而且常用治疗方法对胎儿的风险也各不相同。虽然据报道化疗在孕早期有一些风险,但人们公认在孕中期和孕晚期可以安全使用。

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