Simultaneous pregnancy and leukaemia offer a treatment challenge
The latest case report published in ecancermedicalscience describes the case of a woman who had the double burdens of chronic leukaemia and an unplanned pregnancy – and her happy outcome.
Chronic lymphocytic leukaemia (CLL) is a very common haematological disease, but it usually affects elderly people. Cases of this disease appearing alongside pregnancy are vanishingly rare.
The 36-year-old patient had finished a course of treatment for her already unusual case of CLL when she became unintentionally pregnant. Despite the threat of disease progression, she wished to continue her pregnancy. How would her doctors juggle her desires for sustainable cancer remission and a healthy delivery?
"Our report is unique as it raises awareness about this rare situation and the reproductive issues faced by these patients," says lead author of the report, Dr Fedro Peccatori of the European Institute of Oncology, Milan, Italy.
"Contraception is of utmost importance during oncological treatments and also after treatment, if patients are not interested in having children," Dr Peccatori explains.
"Pregnancy may be successfully pursued during CLL, but the possible influences of the disease on pregnancy and of pregnancy on CLL progression should be thoroughly discussed with the patient."
"When facing such a difficult situation it is mandatory to plan clinical management within a multidisciplinary team, respecting the patient's autonomy and using the best treatment for the mother without endangering the foetus."
"This gives hope to CLL patients – even if they have a chronic disease, they can give birth, but cases are still very few and caution is mandatory."
These take-home messages are key for doctors and patients – but our reporters wanted to know what happened to the baby.
"As described in the paper, the patient had a medically induced-labour with a healthy delivery on Nov 15, 2014," says Dr Peccatori.
"The baby girl was of appropriate weight for gestational age and was breastfed for 11 months, and has not encountered any particular health issues in her first year of life."
Winckler Patricia, Vanazzi Anna, Bozzo Maddalena, Scarfone Giovanna and Peccatori Fedro A (2015) Chronic lymphocytic leukaemia during pregnancy: management and thoughts ecancer 9 592