Leukemia in Pregnancy

Leukemia is known as cancer of the blood. In actual fact, it is a cancerous proliferation of the cells in the bone marrow. These cells give rise to the different types of blood cells in circulation.

The cancerous cells in the marrow spill over into the circulation.

Acute leukemia is the aggressive form of the disease which can become very serious in a matter of days and, without treatment, can kill the patient in two or three months. There will be a severe deficiency of red blood cells, white blood cells and platelets. As mentioned, when untreated; death ensues within about three months.

Chronic leukemia is slowly progressive and may go on for years, even without treatment.

Possibility of leukemia in pregnancy

Acute leukemia is a disease of the younger age groups. In fact, of cancer-related deaths in the reproductive age group (sixteen to forty years), acute leukemia is the second most common!

However, in absolute terms, it remains rare. The incidence is about one in 75,000 pregnancies. An average district hospital will encounter one pregnant woman with leukemia once every twenty years or so.

Pregnancy does not increase the risk of leukemia

Pregnancy effect on the course of leukemia

Pregnancy itself will not affect the course of the disease. However, it may actually cause a delay in diagnosis, which could be critical. At the outset, the symptoms of acute leukemia include non-specific clinical features such as fatigue and breathlessness. These are not uncommon in uncomplicated pregnancy.

A routine blood test at an early stage may reveal anemia as the only abnormality. Again, this is not uncommon in pregnancy and all the symptoms may be put down to this. The unsuspecting doctor may then send the expectant mother away with a prescription of iron supplements and dietary advice. This can be catastrophic, because a delay of just a few days in diagnosis could actually mean the difference between life and death for both mother and baby.

Treatment for acute leukemia in pregnancy

There are different types of acute leukemia and treatment will partly depend on this. Generally speaking, treatment is by combination chemotherapy and the response on the whole is good. This is in the short and medium term.

There is usually a period of maintenance therapy, once the condition has gone into remission.

Relapse is not uncommon and tends to occur within two to five years.

Effect of chemotherapy on the fetus

The fetus is not unduly harmed by chemotherapy, unless the diagnosis was made and treatment commenced in very early pregnancy. As a matter of fact, chemotherapy ensures the survival of the fetus through the survival of the mother, who stands no chance without it.

Termination of pregnancy does not offer any advantage to the treatment.