Acute leukemia diagnosed before conception

If a diagnosis of acute leukemia is made before conception, the woman is advised not to embark upon a pregnancy and effective contraception should be taken.

It is certainly inadvisable to conceive whilst on chemotherapy, since this will expose the embryo to these noxious agents at its most sensitive and vulnerable stage.

Effect of treatment for acute leukemia on future fertility

A majority of affected women who receive chemotherapy for acute leukemia retain their fertility. Nor will a future pregnancy carry any special risk because of her history.

Acute leukemia diagnosed in the first trimester of pregnancy (the first 13 weeks)

In acute leukemia, there is no time to lose. Once the diagnosis is made, treatment has to commence promptly. If the pregnancy is in its early part, when the embryo is quite vulnerable, there is an increased risk of miscarriage as a result of chemotherapy. There is also a risk of fetal abnormalities as a direct result of this. This risk is estimated to be in the region of 10%.

The stark reality is there is no dilemma posed. Chemotherapy has to be given and one hopes for the best for the fetus. The alternative to this is to withhold treatment, where the outcome is not in doubt: both mother and baby will be lost.

Termination of pregnancy simply doesn't feature in the scheme of things.

A child exposed to chemotherapy in the womb as a result of leukemia treatment

Leukemia in pregnancy is a rare condition and whatever we know about children is necessarily based on this very small sample. As such, we have to be cautious in our pronouncements.

Insofar as we know, there are no long-term adverse effects on the child as a result of exposure to these drugs in the womb. More information may emerge in the future, which might alter this perception.

Transmission of acute leukemia from mother to baby in the womb

This is so exceedingly rare that it can, to all intents and purposes, be ignored. In the last hundred years, only two cases of vertical transmission (maternal to fetal) of leukemia have been reported worldwide.

Chronic leukemia and pregnancy

There are few cases of chronic leukemia associated with pregnancy in the medical literature. There are several types of chronic leukemia. One type of chronic leukemia is mainly found in the elderly, so it is exceedingly rare to be associated with pregnancy. This is the chronic lymphocytic leukemia (CLL).

Overall, chronic leukemias are much less aggressive and can run a very long course, often with long spells without need for treatment.

When chemotherapy is required, thorough counseling is mandatory if the woman is not yet pregnant but planning to conceive. Options should include effective contraception during the time of treatment. Chemotherapy immediately before conception or in the early trimester is considered a risk factor (for the fetus).

If the woman is already pregnant and chemotherapy begins later on in pregnancy, the only anticipated problems for the fetus are preterm delivery and low birth-weight. These are the same problems encountered with chemotherapy use in acute leukemia.

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