Leukemia During Pregnancy

Leukemia affects approximately 1 in 10000 pregnancies. Women with leukemia have nonspecific symptoms and some of them could also be attributed to pregnancy. Antineoplastic chemotherapy uses cytotoxic agents with potential adverse effects on the fetus, especially in the first trimester causing malformations or weight gain restriction in the second and third trimester and delay in neurological development during all the pregnancy, but if the therapy is delayed until birth the prognosis for the mother is critical. During pregnancy, it is important to take into account the metabolic changes associated with pregnancy that could impact the bio distribution and drug clearance. The damage in the fetus is correlated with the time of exposition and the fetus is most vulnerable during organogenesis phase. Although chemotherapy has effects in the fetus, there are reports of cases with successful pregnancy. It is necessary to study the relation among chemotherapy, the leukemia and the fetus in long term studies where the fetus has been exposed to chemotherapy agents and is reported with normal characteristics at birth.