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Acute Promyelocytic Leukemia during Pregnancy: Report of 3 Cases

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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. Int J Hematol. 2004;79:31-36.

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Correspondence to Ugo Consoli or Amalia Figuera or Giuseppe Milone or Carmela Rita Meli or Giulia Guido or Francesco Indelicato or Gaetano Moschetti or Salvatore Leotta or Antonella Tornello or Massimo Poidomani or Pamela Murgano or Valeria Pinto or Rosario Giustolisi.

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Consoli, U., Figuera, A., Milone, G. et al. Acute Promyelocytic Leukemia during Pregnancy: Report of 3 Cases. Int J Hematol 79, 31–36 (2004).

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Key words

  • APL
  • ATRA
  • Pregnancy