Leukemia During Pregnancy

Pregnancy makes already a million reasons to take care of health and fitness. Most of the health complications during this phase rarely relate to any major underlying issue. But when talking about leukemia, sure there is the need of elevated outlook and crucial priority. We all have heard about leukemia, at least in general terms. It is defined as the cancer of the blood, and is a cancerous proliferation of the bone marrow. It signifies the abnormal growth in the number of white blood cells. These cells then pass into the blood stream and outnumber the normal and healthy white blood cells, platelets, and red blood cells. Due to excess amount of cancerous white blood cells, the resistance of the body to infections and other attacks becomes weak and poor. These cancerous cells also accumulate in other organs of the body and disturb the normal functioning of each. It is observed that leukemia occurring during pregnancy is extremely rare. Almost 1 in 100,000 women have the possibility of the disease. Most of the time, a routine blood test will reveal if there is any abnormality in the blood. We shall understand more on leukemia and pregnancy, in more detail below.

One of the facts of leukemia is that it is a part of the group of diseases called hematological malignancy. It can be acute - that develops rapidly, and chronic - that which develops very slowly. This cancer can be further classified in four major types. They are - chronic lymphocytic, chronic myeloid, acute lymphocytic, and acute myeloid leukemia. These are divided based on the severity of the cancerous cells. Acute leukemia is a threat, as it develops very fast and can develop into extreme circumstances like death too. Whereas chronic leukemia is a slowly growing cancer, that can take years to pose a serious threat. Due to very few cases of leukemia during pregnancy, very little research has made way till now. Out of the total number of cases, most of the findings were acute, that consisted one third of lymphatic and two third of myeloid. Chronic myeloid leukemia ranked below these cases, and chronic lymphocytic leukemia made an extremely rare case among all.

It is not true that pregnancy is the cause for this dreaded cancer, nor will it affect the course of the disease. But it may affect the diagnostic process, as during the early stage of the disease, a blood test will only reveal typical clinical symptoms like anemia. Other symptoms like breathlessness and fatigue may also be related to pregnancy. This sometimes proves fatal as any delay in case of a typical acute leukemia, can pose a serious threat to both the mother and the baby. According to the cases studied, it was observed that leukemia develops throughout the phase of pregnancy. This can affect the development of the fetus. In severe cases, where treatment was not taken, the fetus showed intrauterine growth retardation (poor growth and development of the baby). There were also instances of pre-term labor, abortion due to medical circumstances, and still birth in acute leukemia cases.

It has not been proved that termination of the pregnancy will help in the treatment. In such cases, an abortion is not advised if the mother does not want the same.

Treatment and Prognosis

For treating leukemia in pregnancy, there is a generalization that it should be treated just like other cases of leukemia. Abortion is an option but can be considered in the early stages only, if the women desires to go for it. In case of continuing the pregnancy, anti-leukemic treatment can be advised with intense caution and care, with taking complete precautions for inducing labor in the safest stages for the mother and the baby both. The treatment for acute leukemia is dependent on the types of acute leukemia possibilities.

• In the case of acute promyelocytic leukemia in pregnancy, treatment becomes critical and is a challenge, there are high risks of mortality in these cases. Treatment options like abortion can also be discussed, and if the pregnancy should continue, chemotherapy is advised with regular fetus monitoring and extreme management of the complications.
• In the case of acute lymphocytic leukemia and pregnancy, immediate treatment is advised. A lot needs to be taken care of due to the risks of the therapy affecting the fetus.
• For cases of acute lymphoblastic leukemia in pregnancy, chemotherapy is advised, and case studies have reported fair results of fetal development and full remission.
• In the case of acute myeloid leukemia, therapy is advised. However, there are major risks to the fetus. Recent progress in therapy may suggest some improvement.

Though there have not been many findings claiming harm to the fetus due to the therapy for treatment, certain cases with treatment in early stage of pregnancy showed certain effects of the therapy on the baby. But relatively after the birth, most children will live healthy without any traces of leukemia in them.

Pregnancy will very rarely have chances of leukemia, and early detection and diagnosis will save a lot, both for the mother and the baby.