a Department of Gynecology and Obstetrics , Tianjin Medical University General Hospital , Tianjin China.
Cancer Biol Ther. 2019;20(4):397-401. doi: 10.1080/15384047.2018.1529122. Epub 2018 Nov 19.
Acute promyelocytic leukemia (APL) is one of the most fatal hematological malignancies. APL during pregnancy is a rare comorbidity and can lead to adverse outcomes, such as maternal and/or fetal death, without timely and appropriate management. Medical management for APL during pregnancy remains challenging. We reported 2 patients with no regular prenatal visits who were diagnosed with APL during pregnancy. One presented with typical hematological abnormalities related to infection, while the other presented with intracranial hemorrhage, which is rare. Although supportive measures and chemotherapy were administered after APL was diagnosed, these two patients had completely different outcomes. The pregnancy outcomes of APL patients depend greatly on the timely diagnosis and appropriate management of the disease. Physicians should pay more attention to APL during pregnancy and thus may save more maternal and fetal lives. Further study of the management of APL during pregnancy is warranted. Abbreviations: AML: acute myeloid leukemia; APL: acute promyelocytic leukemia; WBC: white blood cell; RBC: red blood cell; Hb: hemoglobin; PT: prothrombin time; TT: thrombin time; APTT: activated partial thromboplastin time; TP: total protein; ALB: albumin; AST: aspartate transaminase; ALT: alanine aminotransferase; LDH: lactate dehydrogenase; ATRA: all-trans retinoic acid; ICH: intracranial hemorrhage; DIC: disseminated intravascular coagulation.
急性早幼粒细胞白血病(APL)是最致命的血液系统恶性肿瘤之一。妊娠合并 APL 是一种罕见的并发症,如果不能及时、恰当的处理,可导致母婴死亡。妊娠合并 APL 的治疗仍然具有挑战性。我们报告了 2 例未定期产前检查的患者,她们在妊娠期间被诊断为 APL。其中 1 例表现为与感染相关的典型血液学异常,而另 1 例表现为颅内出血,这是罕见的。虽然在诊断 APL 后给予了支持治疗和化疗,但这 2 例患者的结局完全不同。APL 患者的妊娠结局在很大程度上取决于疾病的及时诊断和恰当处理。医生应更加关注妊娠合并 APL,从而可能挽救更多母婴的生命。有必要进一步研究妊娠合并 APL 的处理方法。缩写:AML:急性髓系白血病;APL:急性早幼粒细胞白血病;WBC:白细胞;RBC:红细胞;Hb:血红蛋白;PT:凝血酶原时间;TT:凝血酶时间;APTT:活化部分凝血活酶时间;TP:总蛋白;ALB:白蛋白;AST:天冬氨酸转氨酶;ALT:丙氨酸氨基转移酶;LDH:乳酸脱氢酶;ATRA:全反式维甲酸;ICH:颅内出血;DIC:弥漫性血管内凝血。