Subscribe to RSS
DOI: 10.1055/s-2006-954955
Acute Myelogenous Leukemia Mimicking a Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome during Pregnancy: Case Report and Review of the Literature
Publication History
Publication Date:
08 November 2006 (online)
![](https://www.thieme-connect.de/media/ajp/200701/lookinside/thumbnails/10.1055-s-2006-954955-1.jpg)
ABSTRACT
Acute leukemia is a rare malignancy of pregnancy. When it develops, there are many complications to consider and management becomes exceedingly difficult. We report a case of acute myelogenous leukemia presenting as preeclampsia and fetal demise at 36 weeks of gestation. A 30-year-old multigravida presented with intrauterine fetal demise at 36 weeks' gestation, hypertension, and thrombocytopenia. The patient received platelet and packed red blood cell transfusion, with concurrent prophylactic magnesium sulfate and dexamethasone treatment. Following labor induction, the patient delivered a nonviable female fetus and suffered a stroke postpartum. Peripheral smear and flow cytometry revealed the patient had acute myeloid leukemia with prominent monocytic differentiation. The patient expired on postpartum day six. Acute leukemia during the pregnancy is associated with an unfavorable outcome.
KEYWORDS
Pregnancy - thrombocytopenia - acute myelogenous leukemia
REFERENCES
- 1 Bishop J M. Oncogenes as hormone receptors. Nature. 1986; 321 112-113
- 2 Daniel L, Condien B, Revillard J P et al.. Presence of oestrogen binding sites and growth-stimulating effect of oestradiol in human myelogenous cell line HL 60. Cancer. 1986; 42 4701-4705
- 3 Catanzanite V A, Ferguson J E. Acute leukemia and pregnancy: a review of management and outcome. Obstet Gynecol Surv. 1984; 39 663-678
- 4 Peleg D, Ben-Ami M. Lymphoma and leukemia complicating pregnancy. Obstet Gynecol Clin North Am. 1998; 25 365-381
- 5 Caligiuri M A, Mayer R J. Pregnancy and leukemia. Semin Oncol. 1989; 16 338-396
- 6 Caligiuri M A. Leukemia and pregnancy: Effects of treatment on mother and child. Adv Oncol. 1992; 8 10
- 7 Meyer R J, Cuttner J, Truog P et al.. Therapeutic leukapheresis of acute myelo-monocytic leukemia in pregnancy. Med Pediatr Oncol. 1978; 4 77-83
- 8 Hurley T J, Mckinnell J V, Irani M S. Hematologic malignancies in pregnancy. Obstet Gynecol Clin North Am. 2005; 32 595-614
-
9 Hoelzer D, Gokbuget N.
Acute lymphocytic leukemia in adults . In: Hoffman R, Benz E, Shattil S, Furie B Hematology: Basic Principles and Practice. 4th ed. Philadelphia; Elsevier 2005: 1177-1185 - 10 McCrae K R, Russel J B, Mannucci P M et al.. Platelets: an update on diagnosis and management of thrombocytopenic disorders. Hematology (Am Soc Hematol Educ Program). 2001; 1 282-305
- 11 Sifakis S, Pharmakides G. Anemia in pregnancy. Ann NY Acad Sci. 2000; 900 125-136
- 12 Chelghoum Y, Vey N, Raffoux E et al.. Acute leukemia during pregnancy: a report on 37 patients and a review of the literature. Cancer. 2005; 104 110-117
- 13 Pizzuto J, Aviles A, Noriega L et al.. Treatment of acute leukemia during pregnancy: presentation of nine cases. Cancer Treat Rep. 1980; 64 679-683
- 14 Reynoso E E, Shepherd F A, Messner H A et al.. Acute leukemia during pregnancy: the Toronto Leukemia Study Group experience with long-term follow-up of children exposed in utero to chemotherapeutic agents. J Clin Oncol. 1987; 5 1098-1106
- 15 Cardonick E, Iacobucci A. Use of chemotherapy during human pregnancy. Lancet Oncol. 2004; 5 283-291
- 16 Avilés A, Neri N. Hematological malignancies and pregnancy. A final report of 84 children who received chemotherapy in utero. Clin Lymph. 2001; 2 173-177
- 17 Aviles A, Neri N, Nambo M J. Long-term evaluation of cardiac function in children who received anthracyclines during pregnancy. Ann Oncol. 2006; 17 286-288
- 18 Bilgrami S, Greenberg B R, Weinstein R E et al.. Recurrent venous thrombosis as the presenting manifestation of acute lymphocytic leukemia: leukemic cell procoagulant activity is not responsible for the hypercoagulable state. Med Pediatr Oncol. 1995; 24 40-45
- 19 Riccio J A, Colley A T, Cera P J. Hepatic vein thrombosis (Budd-Chiari syndrome) in the microgranular variant of acute promyelocytic leukemia. Am J Clin Pathol. 1989; 92 366-371
- 20 Hazani A, Weidenfeld Y, Tatarsky I, Bental E. Acute promyelocytic leukemia presenting as sudden blindness and sinus vein thrombosis. Am J Hematol. 1988; 28 56-57
- 21 Murray J C, Dorfman S R, Brandt M L et al.. Renal venous thrombosis complicating acute myeloid leukemia with hyperleukocytosis. J Pediatr Hematol Oncol. 1996; 18 327-330
- 22 Ohmoto A, Kohno M, Matsuyama R et al.. Acute lymphocytic leukemia with thrombophlebitis of lower limbs and translocation. [in Japanese]. Rinsho Ketsueki. 1990; 31 827-830
- 23 Cardonick E, Iacobucci A. Use of chemotherapy during human pregnancy. Lancet Oncol. 2004; 5 283-291
- 24 Hurley T J, McKinnell J V, Irani M S. Hematologic malignancies in pregnancy. Obstet Gynecol Clin North Am. 2005; 32 595-614
Ramzi AboujaoudeM.D.
200 Baldwin Road, Apt. F25
Parsippany, NJ, 07054